Celiac Disease (Coeliac disease, coeliac sprue)
What is celiac disease?
Symptoms of celiac disease.
How common is celiac disease?
More on CD (Diagnosis, treatment)
What is celiac disease?
Celiac disease is a disorder of the small intestine resulting from a sensitivity to gluten, which is a protein found mostly in wheat but also in other cereals, members of
the Plant Kingdom Subclass of monocots and are members of the grass family of wheat, (oats), barley, rye and triticale.
The gluten sets up an allergic reaction in the small bowel. The small bowel wall is lined microscopic fingers of tissue called villi that reach into the bowel. The villi expand the surface area of the small bowel to give a bigger area to absorb nutrients. Gluten first destroys the little hairs on the villi that help with digestion, then the villi themselves shorten and evetually disappear, leaving asmall bowel wall that is shiny, smooth and incapable of absorbing nutrients. Food goes past undigested, and this causes most of the symptoms.
Symptoms of celiac disease
Symptoms from unabsorbed food:
gas, bloating, abdominal distension and pain, diarrhoea, foul smelling bowel movements.
Symptoms from unabsorbed nutrients:
weight loss, failure to thrive (infants), anemia, enamel loss of teeth, peripheral neuritis from vitamindeficiency, cerebral symptoms from vitamin deficiency such as irritability (children), seizures, fatigue, behavioural changes: osteoporosis, osteopenia.
General effects:
Reduced fertility and miscarriages, delayed onset of periods, skin rash - dermatitis herpitiformis - pathognomonic for CD. Reduced white cells + vitamin deficiency can cause aphthous stomatitis (mouth ulcers).
Prevalence of CD
CD (Celiac Disease) is much more common than previously thought. One study reported a risk in at-risk groups, the prevalence of CD was 1:22 in first-degree relatives, 1:39 in second-degree relatives, and 1:56 in symptomatic patients. The overall prevalence of CD in not-at-risk groups was 1:133. European studies put the prevelance higher, at closer to 1%, and some gastroenterologists specializing in CD say it is much higher than that.
The timing of introduction of gluten to an infants diet is important in children who have the genetic tendency to celiac disease. Those exposed early (1-3 months old) were 5 times more likely than tose exposed at 4-6 months. The tendency is measured by the presence of a gene HLA-DR3 or DR4 .
