Celiac disease (CD) is a autoimmune disease, general requirement to avoid
gluten in the diet. This is a ver common disorder and usually goes undiagnosed. The
disease can be called by other names, celiac sprue, coeliac disease,
dermatitis herpetiformis (DH), and gluten sensitive enteropathy (GSE). Diseases
that can be associated with celiac disease include lactose intolerance,
dermatitis herpetiformis, insulin dependent diabetes mellitus (IDDM), systemic
lupus erythematosus, thyroid disease, and autoimmune disorders. Except for
direct quotations and medical reference to a disease, CD is the universal term
used. Outside the US, the term is often spelled as coeliac.
Gluten is a general term used to describe the toxic protein found in certain
grains or their by-products. The major grains that are avoided are: wheat, rye,
oats, and barley.
History of Celiac Disease.
In 250 A.D., Galen, a Roman physician, described childhood and adult celiac
disease. In 1888, Samuel Gee described celiac disease in Britain and the role of
diet in its control. Dicke in the Netherlands during 1950 suggested that certain
dietary cereal grains were harmful to children with celiac disease. He also
noted that persons previously diagnosed with celiac disease improved during
World War II when grain products were in short supply. When grains became more
plentiful after the war, the incidence of celiac disease returned to its pre-war
levels. In 1954, Paulley first described the intestinal lesion, villus atrophy,
in patients with celiac disease. Cyrus L. Rubin and co-workers in the United
States demonstrated in 1958 that celiac disease in children and adults were
identical disorders. In the 1980's, Michael Marsh and co- workers in Manchester,
England, emphasized the role of the immune system in causing intestinal injury
in celiac disease.
The abnormal villi in celiac disease.
Imagine if you could never have a sandwich, or piece of birthday cake without
it making you ill. That is what it is like to have celiac disease.
One in 179 people in the U.S has celiac disease, which means that there are
1,596,469 celiacs in the U.S.
This is a disease in which the lining of the small intestine is damaged in
response to ingestion of gluten and similar proteins, which are found in wheat,
rye, oats, barley, and other grains including hybrid grains such as triticale.
Symptoms in
Celaic
The exact cause of celiac disease is autoimmune. The development of celiac
disease requires a genetically predisposed person who is eating wheat, rye,
oats, or barley. Even if these two factors are present, celiac disease may not
develop until a "trigger factor" starts the abnormal immune system response.
Sometimes, a viral illness appears to be that "trigger." Celiac disease causes
the intestine's villi to become flattened and lose the ability to absorb
nutrients. Weight loss, anemia, and vitamin deficiencies may occur as a result
of the malabsorption (inadequate absorption of nutrients from the intestinal
tract). After exposure to gluten, intestinal damage may develop within a few
months or may be postponed for several years.
Because the exact cause is unknown, there is no way known to prevent the
development of celiac disease. However, awareness of risk factors (such as a
family member with the disorder) may increase the chance of early diagnosis and
treatment.
Recently developed screening blood tests can help your doctor diagnose this
disease. It's necessary to have these blood tests before you start a gluten
free-diet. If you have dermatitis herpetiformis (an itchy, blistery skin
problem), you have celiac disease. The diagnosis is confirmed with a biopsy
obtained through an endoscopic tube that is put into your intestines.
Total withdrawal of gluten from the diet permits the intestinal mucosa to
heal and results in a disappearance of the symptoms of celiac disease.
Initially, irritability goes away and appetite improves, usually within a matter
of days following withdrawal of dietary gluten. Over a matter of weeks, weight
gain resumes and diarrhea decreases. Several months later, growth in height
returns as abdominal swelling disappears. Blood tests eventually come back to
normal, too. These improvements in overall health and appearance of an affected
person occur long before there has been healing of the intestinal damage.
Blood tests can be done to measure the antigliadin antibody to see if the
person has Celiac disease.
