What is Celiac Disease?

Celiac

According to medlineplus.gov , Celiac disease is an immune disease in which people can’t eat gluten because it will damage their small intestines. Celiac disease is a digestive disease that inhibits the small intestine’s ability to absorb nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, which is found in wheat, rye, and barley. It is most often found in food, although it is also used as a binding agent in some medications and other everyday products.

Celiac disease causes an immune system result that damages the villi, tiny, fingerlike protrusions that line the small intestine. The villi allow nutrients from food to be absorbed into the bloodstream. Without healthy villi, a person becomes malnourished, regardless of the quantity of food eaten.

Since the body’s immune response causes the damage, celiac disease is classified as an autoimmune disorder. It is also considered a malabsorption disease since it prevents nutrients from being absorbed. Other names for celiac disease include gluten-sensitive enteropathy, celiac sprue, and nontropical sprue.

Celiac disease is a genetic disease; most people who have it have at least one blood relative with the disease. The disease often becomes active after pregnancy, childbirth, surgery, viral infection or severe emotional stress.

Symptoms

There is no single symptom of celiac disease, and it affects each person differently. Symptoms can occur in many parts of the body, not only the digestive system. For example, one person might have diarrhea and abdominal pain, while another person may be irritable or depressed. In fact, irritability is one of the most common symptoms in children.

Symptoms may include one or more of the following conditions:

  • recurring abdominal bloating and pain
  • gas
  • chronic diarrhea
  • pale, foul-smelling, or fatty stool
  • weight loss / weight gain
  • muscle cramps
  • fatigue
  • unexplained anemia (a low count of red blood cells causing fatigue)
  • bone or joint pain
  • osteoporosis, osteopenia
  • tooth discoloration or loss of enamel
  • pale sores inside the mouth, called aphthous ulcers
  • behavioral changes
  • tingling numbness in the legs (from nerve damage)
  • seizures
  • itchy skin rash called dermatitis herpetiformis
  • missed menstrual periods (often because of excessive weight loss)
  • infertility, recurrent miscarriage
  • delayed growth
  • failure to thrive in infants

Celiac
Celiac is usually asymptomatic. However, people without symptoms are still at risk for complications, including malnutrition. The longer it goes undiagnosed and untreated, the higher the chance of malnutrition and other complications. Malnutrition, in children, can cause delayed growth and other development problems.

Researchers are studying the reasons why symptoms vary so widely. The length of time a person is breastfed, the age a person started eating gluten-containing foods, and the amount of gluten-containing foods you eat are three factors thought to play a role in the presentation of celiac. According to studies, the longer a person was breastfed, the later the symptoms appear.

Diagnosis

The easiest way to test for celiac disease is through a blood test. Research has shown that people with celiac disease have above average levels of specific autoantibodies in the blood. These protective proteins are usually produced to shield the body from perceived threats. But, in patients with celiac disease, they instead attack their villi.

Since celiac disease is hereditary, family members, particularly first degree relatives of people who have been diagnosed may wish to be tested for the disease. About 5 to 15 percent of an affected person’s immediate family will also have the condition. About 3 to 8 percent of people with type 1 diabetes will have biopsy-confirmed celiac disease, and 5 to 10 percent of people with Down syndrome will be diagnosed.

Before testing is performed, you should not alter your diet. Restricting your gluten intake can produce a false negative result in the blood test. Gluten needs to be present in your system for your body to produce the offending autoantibodies in most cases.

If the tests and symptoms suggest celiac disease, Dr. Tabib will perform a small bowel biopsy. During the biopsy, he removes a tiny piece of tissue from the small intestine to check for damage to the villi. The sample is taken using a long, thin tube called an endoscope. To get tested, contact us to make an appointment with Dr. Tabib today. Early detection and treatment is the key to avoiding possible complications.

Treatment

The only treatment available for celiac disease is to follow a gluten-free diet. Follow diagnosis; most patients meet with a professional dietician to learn about how to avoid gluten. This may include avoiding certain foods and knowing what to look for on labels, as many processed foods containing gluten.

For most, the gluten-free diet will stop symptoms, heal existing intestinal damage, and prevent further complications. Most people experience some immediate improvements once they eliminate gluten from their diets. It usually takes 3 to 6 months in children and younger adults and two years for older adults to be healed entirely. The villi will be healthy enough to absorb nutrients from food into the bloodstream.

Complications

Malabsorption issues put a patient with celiac disease at risk for malnutrition and anemia, among other health problems.

  • Cancer can develop in the intestine, including lymphoma and adenocarcinoma.
  • Poor calcium absorption contributes to osteoporosis, which makes the bones weak, brittle and prone to breaking.
  • Birth defects and miscarriage are risks for pregnant women with untreated celiac disease.
  • Malnutrition can adversely affect a child’s normal growth and development. Children who are diagnosed and treated before their growth stops may have a catch-up period.
  • A lack of folic acid causes calcium deposits to form in the brain, which in turn cause seizures.

Dermatitis Herpetiformis

Dermatitis herpetiformis (DH) is a severe itching, blistering skin condition found in people with celiac disease. The rash usually occurs on the knees, elbows, and buttocks. About 20 percent of people with DH also have intestinal symptoms of celiac disease. Like celiac, DH is diagnosed using a blood test and a biopsy, this time on the patient’s skin. Fortunately, DH improves in response to a gluten-free diet, much like celiac disease.

Today, gastroenterology conditions can be treated effectively. We provide everyone a personalized gastroenterology treatment plan to meet your unique needs and improve your quality of life. Contact our gastroenterology and hepatology center to schedule a consolation with Los Angeles’ preferred Gastroenterologist– Dr. Tabib.

Dr. Tabib’s completed his postgraduate fellowship, residency, and internships at the UCLA/Cedar-Sinai Medical Center.

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