Description

Celiac disease is a disease caused by an immune reaction to eating gluten. Gluten is a protein found in foods that contain wheat, barley or rye.

If you have celiac disease, eating gluten triggers an immune response to the protein gluten in the small intestine. With time, this reaction damages your small intestine's lining and prevents the absorption of nutrients, a condition called malabsorption.

The intestinal damage often causes symptoms such as diarrhea, fatigue, weight loss, bloating and anemia. It can also lead to serious complications if not handled or treated. In children, malabsorption can affect growth and development, in addition to the gastrointestinal symptoms.

There is not a definite cure for celiac disease. But for most people, following a strict gluten-free diet can help manage symptoms and help the intestines to heal.

Symptoms

The symptoms of celiac disease can vary greatly. You can also be different in children and adults. Digestive symptoms for adults include:

  • The diarrhea.
  • Fatigue.
  • The loss of weight.
  • The bloating and gas.
  • The Abdominal pain.
  • Nausea and vomiting.
  • The constipation.

However, more than half of adults with celiac disease have symptoms that are not related to the digestive system, including:

  • Anemia, usually from iron deficiency due to the decreased absorption of iron.
  • The loss of bone density, osteoporosis, or softening of bones, called osteomalacia.
  • Itchy, blistery skin rash called dermatitis herpetiformis.
  • Ulcers in the mouth.
  • The headaches and fatigue.
  • Nervous system injury, including numbness and tingling in the feet and hands, and possible problems with balance, and cognitive impairment.
  • Pain in the joints.
  • Reduced functioning of the spleen, known as hyposplenism.
  • Elevation of liver enzymes.

Children

Children with celiac disease are more likely than adults to have digestive problems, including:

  • Nausea and vomiting.
  • The chronic diarrhea.
  • The bloated belly.
  • The constipation.
  • Gas.
  • Pale, foul-smelling stools.

The inability to absorb nutrients, could result in:

  • Failure to thrive for children.
  • Damage to the enamel of the teeth.
  • The loss of weight.
  • Anemia.
  • Irritability.
  • Of short stature.
  • The delay of puberty.
  • Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), learning disorders, headaches, lack of muscle coordination and seizures.

Dermatitis herpetiformis

Gluten intolerance can cause this blistery skin disease. The rash usually occurs on the elbows, the knees, the torso, the head or the buttocks. This condition is often associated with changes in the lining of the small intestine identical to those of celiac disease, but the condition of the skin may not cause digestive symptoms.

The health professionals in the treatment of dermatitis herpetiformis with a gluten-free diet or medicine, or both, for the control of the eruption.

When to see a doctor

Check with your health care team if you have diarrhea or digestive discomfort that lasts more than two weeks. Consult your child's healthcare team if your child:

  • Is pale.
  • Is irritable.
  • It is not to grow.
  • Have a belly.
  • Has a bad odor, bulky stool.

Be sure to consult your health care team before you try a gluten-free diet. If you stop or even reduce the amount of gluten you eat before the test for celiac disease, can change the results of the test.

Celiac disease is hereditary. If someone in your family has the condition, ask a member of your health care team if you should be tested. Also, ask about the tests if you or someone in your family has a risk factor for celiac disease, such as type 1 diabetes.

Causes

Your genes, combined with the consumption of foods containing gluten and other factors, may contribute to coeliac disease. However, the exact cause is not known. Infant-feeding practices, gastrointestinal infections and bacteria in the gut can contribute, but these causes have not been tested. Sometimes celiac disease is active after surgery, pregnancy, childbirth, viral infection or severe emotional stress.

When the body's immune system overreacts to gluten in foods, the reaction of the damage of the small, hairlike projections, called villi that line the small intestine. Villi, which absorb the vitamins, minerals and other nutrients from the food that you eat. If your villi are damaged, you may not get enough nutrients, no matter how much you eat.

Risk factors

Celiac disease tends to be more common in people who have:

  • A family member with celiac disease or dermatitis herpetiformis.
  • Type 1 diabetes.
  • Down syndrome, William syndrome or Turner syndrome.
  • Autoimmune thyroid disease.
  • Microscopic Colitis.
  • Addison's disease.

Complications

The celiac disease that is not treated can lead to:

  • Malnutrition. This occurs if the intestine can't absorb enough nutrients. Malnutrition can lead to anemia and loss of weight. In children, malnutrition can lead to slow growth and short stature.
  • Weakening of the bones. In children, malabsorption of calcium and vitamin D can lead to a weakening of the bone, called osteomalacia, or rickets. In adults, it can lead to a loss of bone density, called osteopenia or osteoporosis.
  • Infertility and miscarriage. The malabsorption of calcium and vitamin D may contribute to reproductive problems.
  • Lactose intolerance. The damage to the small intestine can cause abdominal pain and diarrhea after eating or drinking dairy products that contain lactose. Once the bowel has healed, you may be able to tolerate dairy again.
  • Cancer. People with celiac disease who do not maintain a gluten-free diet have a greater risk of developing several types of cancer, including intestinal lymphoma and small bowel cancer.
  • Diseases of the nervous system. Some people with celiac disease can develop conditions such as seizures or a condition of the nerves of the hands and feet, called peripheral neuropathy.

Do not respond celiac disease

Some people with celiac disease do not respond to what they consider a gluten-free diet. Do not respond to the celiac disease is often due to contamination of the diet with gluten. Working with a dietitian can help you learn how to avoid all gluten.

People with nonresponsive celiac disease may have:

  • Bacterial overgrowth in the small intestine.
  • Microscopic Colitis.
  • Poor function of the pancreas, known as pancreatic insufficiency.
  • The Irritable bowel syndrome.
  • Difficulty to digest the sugar found in dairy products (lactose), table sugar (sucrose), or a type of sugar found in honey and fruit (fructose).
  • Really refractory celiac disease that does not respond to a gluten-free diet.

Refractory celiac disease

Rarely, the intestinal injury of coeliac disease does not respond to a strict gluten-free diet. This is known as refractory celiac disease. If you still have symptoms after following a gluten-free diet for 6 months to 1 year, you should talk with your health care team to see if you need more tests to look for explanations for their symptoms.

Diagnosis

Many people with celiac disease do not know they have it. Two blood tests can help diagnose:

  • Serologic testing looks for antibodies in your blood. Elevated levels of certain antibody proteins indicate an immune reaction to gluten.
  • Genetic testing for human leukocyte antigens (HLA-DQ2 and HLA-DQ8) can be used to rule out celiac disease.

It is important to get tested for celiac disease before trying a gluten-free diet. Removing gluten from your diet might make the results of blood tests that appear in the standard range.

If the results of these tests indicate that celiac disease, one of the following tests is likely to be ordered:

  • Endoscopy. This test uses a long tube with a tiny camera is put into your mouth and down her throat. The camera allows the practitioner to the sight of her small intestine and take a small tissue sample, called a biopsy, for the analysis of damage to the villi.
  • The capsule endoscopy. This test uses a tiny wireless camera to take pictures of the entire small intestine. The camera sits inside a vitamin-sized capsule, which is swallowed. As the capsule travels through your digestive tract, the camera takes thousands of pictures that are transmitted to a recorder. This test is used in some situations in which an examination of all or part of the small intestine that is desired.

If you could have dermatitis herpetiformis, your health care professional may take a small sample of skin tissue for examination under a microscope.

If you are diagnosed with celiac disease, additional tests may be recommended to check your nutritional status. This includes the levels of vitamins a, B-12, D, and E, as well as the levels of minerals, haemoglobin and liver enzymes. The health of the bones can also be verified with an analysis of the bone density.

Treatment

A strict and lifelong gluten-free diet is the only way to manage celiac disease. In addition to wheat, the foods that contain gluten are:

  • Barley.
  • The Bulgur.
  • Durum.
  • Farina.
  • Graham flour.
  • The malta.
  • Rye.
  • The semolina.
  • Spelt (a form of wheat).
  • The Triticale.

A nutritionist who works with people with celiac disease can help you plan a healthy gluten-free diet. Even small amounts of gluten in your diet can be harmful, even if they do not cause any symptoms.

Gluten can be hidden in food, drugs and non-food products, including:

  • Modified food starch, preservatives, and stabilizers for food.
  • Prescription and over-the-counter medications.
  • Supplements of vitamins and minerals.
  • Herbal and nutritional supplements.
  • Lipstick of the products.
  • The toothpaste and mouthwash.
  • Hosts.
  • On and seal the tail.
  • Clay.
  • Certain makeup products.

Removing gluten from your diet is usually to reduce inflammation in the small intestine, causing you to feel better and eventually heal. Children tend to heal more quickly than adults.

Supplements of vitamins and minerals

If your anemia or nutritional deficiencies are severe, supplements may be recommended, including:

  • Copper.
  • Folic acid.
  • Iron.
  • Vitamin B-12.
  • The Vitamin D.
  • The Vitamin K.
  • Zinc.

Vitamins and supplements are usually taken in pill form. If your digestive tract has problems absorbing vitamins, you might be able to get by injection.

The follow-up care

The medical follow-up at regular intervals, you can ensure that your symptoms have responded to the gluten-free diet. Your health care team can monitor your response with evidence of blood. The nutritional markers are also reviewed regularly.

To the majority of people with celiac disease, eating a gluten-free diet allows the small intestine to heal. For the children, which usually takes 3 to 6 months. For adults, complete healing may take several years.

If symptoms persist or if symptoms recur, you might need an upper endoscopy with biopsy to determine if the gut has healed.

Medications to control intestinal inflammation

If the small intestine is severely damaged or is refractory celiac disease, steroids may be recommended for the control of inflammation. Steroids can alleviate the severe symptoms of celiac disease, while the gut is healing.

Other drugs, such as azathioprine (Azasan, Imuran), or budesonide (Entocort EC, Uceris), could be used.

The treatment of dermatitis herpetiformis

If you have this rash on the skin, a medicine called dapsone may be recommended in addition to a gluten-free diet. Dapsone is taken by mouth. If you are taking dapsone, you will need regular blood tests to check for side effects.

Refractory celiac disease

With refractory celiac disease, the small intestine does not heal. Refractory celiac disease can be quite serious, and there is currently no proven treatment. If you have refractory celiac disease, you may want to seek medical care in a specialized center.

Lifestyle and home remedies

If you have been diagnosed with celiac disease, you'll need to avoid all foods that contain gluten. Ask your health care team for a referral to a dietitian, who can help you plan a healthy gluten-free diet.

Read the labels

Avoid packaged foods, unless they are labeled as gluten-free, or do not have gluten-containing ingredients, including emulsifiers and stabilizers that may contain gluten. In addition to cereals, pastries and bakery products, other processed foods that may contain gluten are:

  • Beers, beers, beers and malt vinegars.
  • The candies.
  • Sauces.
  • Imitation meat or seafood.
  • Lunch of processed meats.
  • Mixtures of rice.
  • Salad dressings and sauces, including soy sauce.
  • Seasoned snack foods, such as the tortilla and potato chips.
  • The seitan.
  • Self-basting poultry.
  • Soups.

Pure oats are not harmful to the majority of people with celiac disease, but oats can be contaminated by wheat during growing and processing. Ask your health care team if you can, try eating small amounts of pure oat products.

Allowed foods

Many of the basic foods are allowed on a gluten-free diet, including:

  • Eggs.
  • Fresh meat, fish and poultry that are not breaded, batter-coated or marinated.
  • Fruits.
  • The lentils.
  • Most of the dairy products, unless your symptoms get worse.
  • Nuts.
  • Potatoes.
  • Vegetables.
  • Wine and distilled spirits, ciders and spirits.

Grains and starches are allowed in a gluten-free diet include:

  • The amaranth.
  • The buckwheat.
  • Corn.
  • The corn flour.
  • Gluten-free flours (rice, soy, corn, potato, bean).
  • Pure corn tortillas.
  • The quinoa.
  • Rice.
  • The Tapioca.
  • The wild rice.

Coping and support

It can be difficult and stressful, to follow a completely gluten-free diet. Here are some ways to help you cope and feel more in control.

  • Educate and teach family and friends. You can support their efforts in dealing with the disease.
  • Follow your healthcare professional's recommendations. It is essential to eliminate all gluten from your diet.
  • Find a support group. You may find comfort in sharing your struggles with people who face similar challenges. Organizations such as the Celiac Disease Foundation, Gluten Intolerance Group, the National Association of Celiac disease and Beyond Celiac can help put you in touch with others who share your challenges.

Preparing for your appointment

You may be referred to a doctor who treats diseases of the digestive system, called a gastroenterologist. Here's some information to help you prepare for your appointment.

What you can do

Until his appointment, continue to eat your normal diet. Cut the gluten before the test for celiac disease may change the results of the test.

Make a list of:

  • Your symptoms, including when they started and if they have changed over time.
  • Key personal information, including major stresses or recent life changes, and if someone in your family has celiac disease or another autoimmune disease.
  • All medications, vitamins or supplements that you take, including over-dose.
  • Questions during your appointment.

Celiac disease questions include:

  • What is the most likely cause of my symptoms?
  • Is my condition temporary or long-term?
  • What tests do I need?
  • What treatments can help?
  • Do I have to follow a gluten-free diet?

Do not hesitate to ask other questions.

What to expect from your doctor

You can do the following questions:

  • How severe are the symptoms?
  • Have been continuous or occasional?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • What medications and pain relievers do you take?
  • Have you been diagnosed with anemia or osteoporosis?
Symptoms and treatment of Celiac disease