|
What is Celiac Disease?
Celiac disease is an inherited autoimmune disorder that results in damage to the small intestine. The small intestine is normally lined with finger-like projections known as villi that play an important role in the digestion and absorption of food.
An autoimmune disorder occurs when the immune system, which normally fights infections, instead turns against one of the organs of the body. In the case of celiac disease, exposure to wheat and certain grains containing gluten leads to immune system activation and damage to the small intestinal lining. As a result, the small intestinal villi become "flattened" and cannot properly digest and absorb food.
What are symptoms of celiac disease?
The most recognized symptoms of celiac disease are:
- Diarrhea
- Abdominal pain
- Weight loss (or failure to gain weight appropriately in childhood)
In childhood, celiac disease classically presents with diarrhea, abdominal bloating, poor appetite, failure to gain weight and irritability between 9 and 18 months of age. However, the symptoms of celiac disease may begin at any age.
Recently, it has been recognized that celiac disease may cause a variety of atypical symptoms, such as:
- Delayed puberty
- Short stature
- Chronic fatigue
- Dermatitis herpetiformis, a skin rash
- Behavioral and emotional problems
- Enamel defects of teeth
- Recurrent canker sores
In many individuals, celiac disease causes no overt symptoms, but still may impair absorption of iron, calcium and other important nutrients.
How is celiac disease diagnosed?
Often, children with symptoms suggesting celiac disease, or children who are at high risk to develop celiac disease, have a screening blood test performed as a first step. The most commonly performed screening tests are the: anti-gliadin antibody, the anti-endomysial antibody and the anti-tissue transglutaminase antibody.
Individuals with positive tests then undergo an intestinal biopsy to confirm the diagnosis of celiac disease.
Although the blood tests are quite accurate, there are individuals with celiac disease who have negative tests and individuals without celiac disease who have positive tests. The biopsy is performed using a procedure known as an endoscopy, which involves passing a soft flexible tube through the mouth and stomach into the small intestine. Small pieces of tissue are taken from the small intestine and examined under a microscope. Biopsies from patients with celiac disease will show evidence of activation of the immune system and damage to the villi.
How is celiac disease treated?
Celiac disease is completely controllable by diet. A strict gluten-free diet will eliminate all damage to the small intestine villi. It is important to note that the diet must contain no gluten and must be continued for life. In order to learn the diet, families should consult with an experienced dietitian. Support groups can also be valuable sources of information.
What are the risks of not following the diet?
Patients with untreated celiac disease have an increased risk of developing certain kinds of cancer and may also be at a higher risk of developing other autoimmune diseases.
|
