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Coeliac Disease

<br>If you are suffering from Diarrhea, Weight loss, Abdominal or any other discomfort when you eat food containing gluten, then it may be Coeliac Disease. Checkout this article to know more about this article. Coeliac Disease | Celiac Disease article covers all the topics of the disease like Symptoms, Treatment, Diagnosis, Diet, Definition, etc.

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Coeliac Disease

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  1. CoeliacDisease|CeliacDisease Snippet:CoeliacDisease|CeliacDiseasearticlecoversall thetopicsofthediseaselikeSymptoms,Treatment, Diagnosis,Diet,Definition,etc., IfyouaresufferingfromDiarrhea,Weightloss,Abdominalorany otherdiscomfortwhenyoueatfoodcontaininggluten,thenit maybeCoeliacDisease.Checkoutthisarticletoknowmore aboutthisarticle.CoeliacDisease|CeliacDiseasearticle coversallthetopicsofthediseaselikeSymptoms,Treatment, Diagnosis,Diet,Definition,etc., 1.About Celiacdisease(gluten-sensitiveenteropathy),sometimescalled sprueorcoeliac,isanimmunereactiontoeatinggluten,aproteinfoundinwheat,barleyandrye. Ifyouhaveceliacdisease,eatingglutentriggersanimmune responseinyoursmallintestine.Overtime,thisreaction damagesyoursmallintestine'sliningandpreventsabsorptionof somenutrients(malabsorption).Theintestinaldamageoften causesdiarrhea,fatigue,weightloss,bloatingandanemia,and canleadtoseriouscomplications. Inchildren,malabsorptioncanaffectgrowthanddevelopment,in additiontothesymptomsseeninadults. There'snocureforceliacdisease—butformostpeople, followingastrictgluten-freedietcanhelpmanagesymptomsandpromoteintestinalhealing. 2.Symptoms

  2. Thesignsandsymptomsofceliacdiseasecanvarygreatlyand aredifferentinchildrenandadults.Themostcommonsignsfor adultsarediarrhea,fatigueandweightloss.Adultsmayalso experiencebloatingandgas,abdominalpain,nausea, constipation,andvomiting. However,morethanhalfofadultswithceliacdiseasehavesigns andsymptomsthatarenotrelatedtothedigestivesystem. 2.1.CeliacDiseaseSymptomsInAdults Anemia,usuallyresultingfromirondeficiency Lossofbonedensity(osteoporosis)orsofteningofbone (osteomalacia) Itchy,blisteryskinrash(dermatitisherpetiformis) Damagetodentalenamel Mouthulcers Headachesandfatigue Nervoussysteminjury,includingnumbnessandtinglingin thefeetandhands,possibleproblemswithbalance,and cognitiveimpairment Jointpain Reducedfunctioningofthespleen(hyposplenism)Acidrefluxandheartburn • • • • • • • • • • 2.2.CeliacDiseaseSymptomsInChildren Inchildrenunder2yearsold,typicalsignsandsymptomsof celiacdiseaseinclude: •Vomiting •Chronicdiarrhea •Swollenbelly •Failuretothrive •Poorappetite •Musclewasting •Olderchildrenmayexperience:

  3. •Diarrhea •Constipation •Weightloss •Irritability •Shortstature •Delayedpuberty •Neurologicalsymptoms,includingattention- deficit/hyperactivitydisorder(ADHD),learningdisabilities, headaches,lackofmusclecoordinationandseizures 3.Whentoseeadoctor Consultyourdoctorifyouhavediarrheaordigestivediscomfort thatlastsformorethantwoweeks.Consultyourchild'sdoctorif yourchildispale,irritableorfailingtogroworhasapotbellyand foul-smelling,bulkystools. Besuretoconsultyourdoctorbeforetryingagluten-freediet.If youstoporevenreducetheamountofglutenyoueatbeforeyou'retestedforceliacdisease,youmaychangethetestresults. Celiacdiseasetendstoruninfamilies.Ifsomeoneinyourfamily hasthecondition,askyourdoctorifyoushouldbetested.Also askyourdoctorabouttestingifyouorsomeoneinyourfamily hasariskfactorforceliacdisease,suchastype1diabetes. 4.Causes Celiacdiseaseoccursfromaninteractionbetweengenes,eating foodswithglutenandotherenvironmentalfactors,butthe

  4. precisecauseisn'tknown.Infantfeedingpractices, gastrointestinalinfectionsandgutbacteriamightcontributetodevelopingceliacdisease. Sometimesceliacdiseaseistriggered—orbecomesactivefor thefirsttime—aftersurgery,pregnancy,childbirth,viralinfectionorsevereemotionalstress. Whenthebody'simmunesystemoverreactstogluteninfood,the reactiondamagesthetiny,hair-likeprojections(villi)thatlinethe smallintestine.Villiabsorbvitamins,mineralsandothernutrients fromthefoodyoueat.Ifyourvilliaredamaged,youcan'tget enoughnutrients,nomatterhowmuchyoueat. Somegenevariationsappeartoincreasetheriskofdeveloping thedisease.Buthavingthosegenevariantsdoesn'tmeanyou'll getceliacdisease,whichsuggeststhatadditionalfactorsmustbe involved. TherateofceliacdiseaseinWesterncountriesisestimatedat about1percentofthepopulation.Celiacdiseaseismostcommon inCaucasians;however,itisnowbeingdiagnosedamongmany ethnicgroupsandisbeingfoundglobally. 5.RiskFactors Celiacdiseasecanaffectanyone.However,ittendstobemore commoninpeoplewhohave:

  5. •Afamilymemberwithceliacdiseaseordermatitis herpetiformis •Type1diabetes •DownsyndromeorTurnersyndrome •Autoimmunethyroiddisease •Microscopiccolitis(lymphocyticorcollagenouscolitis) •Addison'sdisease •Rheumatoidarthritis 6.Complications Untreated,celiacdiseasecancause: 6.1.Malnutrition Thedamagetoyoursmallintestinemeansitcan'tabsorbenough nutrients.Malnutritioncanleadtoanemiaandweightloss.Inchildren,malnutritioncancauseslowgrowthandshortstature. 6.2.LossOfCalciumAndBoneDensity MalabsorptionofcalciumandvitaminDmayleadtoasoftening ofthebone(osteomalaciaorrickets)inchildrenandalossofbonedensity(osteoporosis)inadults. 6.3.InfertilityAndMiscarriage MalabsorptionofcalciumandvitaminDcancontributeto reproductiveissues. 6.4.LactoseIntolerance Damagetoyoursmallintestinemaycauseyoutoexperience abdominalpainanddiarrheaaftereatinglactose-containingdairyproducts,eventhoughtheydon'tcontaingluten.Onceyour

  6. intestinehashealed,youmaybeabletotoleratedairyproducts again.However,somepeoplecontinuetoexperiencelactoseintolerancedespitesuccessfulmanagementofceliacdisease. 6.5.Cancer Peoplewithceliacdiseasewhodon'tmaintainagluten-freediet haveagreaterriskofdevelopingseveralformsofcancer,includingintestinallymphomaandsmallbowelcancer. 6.6.NeurologicalProblems Somepeoplewithceliacdiseasemaydevelopneurological problemssuchasseizuresorperipheralneuropathy(diseaseofthenervesthatleadtothehandsandfeet). Inchildren,celiacdiseasecanalsoleadtofailuretothrive, delayedpuberty,weightloss,irritabilityanddentalenameldefects,anemia,arthritis,andepilepsy. 7.NonresponsiveCeliacDisease Asmanyas30percentofpeoplewithceliacdiseasemaynot have,orbeabletomaintain,agoodresponsetoagluten-free diet.Thiscondition,knownasnonresponsiveceliacdisease,is oftenduetocontaminationofthedietwithgluten.Thereforeit's importanttoworkwithadietitian. Peoplewithnonresponsiveceliacdiseasemayhaveadditional conditions,suchasbacteriainthesmallintestine(bacterial overgrowth),microscopiccolitis,poorpancreasfunction, irritablebowelsyndromeorintolerancetodisaccharides(lactose andfructose).Or,theymayhaverefractoryceliacdisease.

  7. 8.RefractoryCeliacDisease Inrareinstances,theintestinalinjuryofceliacdiseasepersists andleadstosubstantialmalabsorption,eventhoughyouhave followedastrictgluten-freediet.Thiscombinationisknownas refractoryceliacdisease. Ifyoucontinuetoexperiencesignsandsymptomsdespite followingagluten-freedietforsixmonthstooneyear,your doctormayrecommendfurthertestingandlookforother explanationsforyoursymptoms.Yourdoctormayrecommend treatmentwithasteroidtoreduceintestinalinflammation,ora medicationthatsuppressesyourimmunesystem.Allpatients withceliacdiseaseshouldbefolloweduptomonitortheresponse oftheirdiseasetotreatment. 9.Diagnosis Researchersestimatethatonly20percentofpeoplewithceliac diseasemayreceiveadiagnosis. Doctorsmayordertwobloodteststohelpdiagnoseceliac disease. Serologytestinglooksforantibodiesinyourblood.Elevated levelsofcertainantibodyproteinsindicateanimmunereactiontogluten. Genetictestingforhumanleukocyteantigens(HLA-DQ2andHLA- DQ8)canbeusedtoruleoutceliacdisease.

  8. Iftheresultsofthesetestsindicateceliacdisease,yourdoctor mayorderanendoscopytoviewyoursmallintestineandtotakeasmalltissuesample(biopsy)toanalyzefordamagetothevilli. It'simportanttobetestedforceliacdiseasebeforetryinga gluten-freediet.Eliminatingglutenfromyourdietmaychangetheresultsofbloodtestssothattheyappeartobenormal. 10. Treatment Astrict,lifelonggluten-freedietistheonlywaytomanageceliac disease.Inadditiontowheat,foodsthatcontaingluteninclude: Barley Bulgur Durum Farina Grahamflour MaltRye Semolina Spelt(aformofwheat) Triticale • • • • • • • • • • Yourdoctormayreferyoutoadietitian,whocanhelpyouplana healthygluten-freediet. Onceyouremoveglutenfromyourdiet,inflammationinyour smallintestinegenerallybeginstolessen—usuallywithinseveral weeks,thoughyoumaystarttofeelbetterinjustafewdays. Completehealingandregrowthofthevillimaytakeseveral monthstoseveralyears.Healinginthesmallintestinetendsto occurmorequicklyinchildrenthanadults.

  9. Ifyouaccidentallyeataproductthatcontainsgluten,youmay experienceabdominalpainanddiarrhea.Somepeople experiencenosignsorsymptomsaftereatinggluten,butthis doesn'tmeanit'snotharmfultothem.Eventraceamountsof gluteninyourdietcanbedamaging,whetherornottheycause signsorsymptoms. Hiddenglutencanbepresentinfoods,medicationsandnonfood products,including: •Modifiedfoodstarch,preservativesandfoodstabilizers •Prescriptionandover-the-countermedications •Vitaminandmineralsupplements •Herbalandnutritionalsupplements •Lipstickproducts •Toothpasteandmouthwash •Envelopeandstampglue •Play-Doh •Vitaminandmineralsupplements Ifyournutritionaldeficienciesaresevere,yourdoctoror dietitianmayrecommendtakingvitaminandmineralsupplements.Youmayneedtosupplementyourlevelsof: •Calcium •Folate •Iron •VitaminB-12 •VitaminD •VitaminK

  10. •Zinc Vitaminsandsupplementsareusuallytakeninpillform.Ifyour digestivetracthastroubleabsorbingvitamins,yourdoctormay givethembyinjection.Youneedtobesurethatthevitaminsand supplementsaregluten-free. 11. Follow-UpCare Ifyouhaveceliacdisease,youwillneedmedicalfollow-upto makesureyoursymptomshaverespondedtoagluten-freediet. Doctorswillalsowanttobesureyouaregettingthesupportyou needtomaintainthedietforlife.Theywillusebloodteststo monitoryourresponse.Theresultsofthesetests,whichare primarilydesignedasawaytodetectceliacdisease,usually becomenegativeonceyouhavebeengluten-freeforsixto12 months.Iftestresultsremainpositive,thenyourdoctormaytry tofindthereason,themostcommonbeingunintentional exposuretogluteninyourdiet. However,thesetestsarenotperfect,andeveniftheresults becomenegative,itispossiblethatyoucouldstillbeexposedto asignificantamountofglutenandcontinuetohavesymptoms anddamagetoyourintestines. Ifyoucontinuetohavesymptoms,oryoursymptomsrecur,you mayneedafollow-upendoscopywithbiopsiestoensurethat healinghasoccurred.Adultstypicallyhaveagreaterneedfor follow-uptesting,althoughchildrenmayrequireit,too.Some doctorsrecommendaroutinere-biopsyifyouarediagnosedin adulthood,ashealingisoftenquiteslowanduncertain.

  11. Italsocanbehelpfultofollowupwithanexpertdietitianfor assistanceinadaptingto,andmaintaining,ahealthy,nutritious,gluten-freediet. 11.1. MedicationsToControlIntestinalInflammation Ifyoursmallintestineisseverelydamaged,yourdoctormay recommendsteroidstocontrolinflammation.Steroidscanease severesignsandsymptomsofceliacdiseasewhiletheintestine heals. 11.2. DermatitisHerpetiformis Ifyouhavethisitchy,blisteringskinrashthatsometimes accompaniesceliacdisease,yourdoctormayrecommendaskinmedication(dapsone)alongwiththegluten-freediet. 11.3. RefractoryCeliacDisease Ifyouhaverefractoryceliacdisease,youmaycontinuetohave severesymptoms,oryoursymptomsmaylessenbutthen relapse.Ineithercase,yoursmallintestinedoesnotheal.When thishappens,youlikelywillrequireevaluationinaspecialized center.Refractoryceliacdiseasecanbequiteseriousandthereis currentlynoproventreatment. Peoplewithrefractoryceliacdiseaseshouldbetreatedby experts.Theremaybeseveralcausesforthiscondition.Doctorswilloftenusesteroidtherapy—eitheratopicalbudesonideor

  12. systemicsteroidssuchasprednisone.Sometimes,theywilluse thesamemedicationsusedtotreatotherconditions. 11.4.PotentialFutureTreatments Whiletheonlyproventherapyforceliacdiseaseisagluten-free diet,itisnotperfect.Peoplewithceliacdiseasemayoftenbe accidentallyexposedtogluten,possiblycausingsevere symptoms. Severaltreatmentsareindevelopmentforceliacdisease.Some trytoneutralizeorbindtogluten.Othersaddressthebarrierof theintestine,blockingtheleakinessthatglutencantrigger.Still otherstargetthebody'simmunesystem.Researchershavealso beentryingtogeneticallymodifywheat,buthavenotyetbeen successful. Noneofthesetreatmentsislikelytobeapprovedwithinthenext twotothreeyears.However,giventhenumberofdifferent approaches,thereisagoodchancethattherewillbeadditional treatmentsavailableforceliacdiseaseinthefuture. 12. LifestyleAndHomeRemedies Ifyou'vebeendiagnosedwithceliacdisease,you'llneedtoavoid allfoodsthatcontaingluten.Askyourdoctorforareferraltoa dietitian,whocanhelpyouplanahealthygluten-freediet.It's

  13. importanttogetenoughvitamins,nutrients,fiberandcalciumin yourdiet. Here'sanoverviewoffoodsthatcontainglutenandgluten-free foodsthataresafetoeat. 12.1. AlwaysAvoid Avoidfoodanddrinkscontaining: Barley Bulgur Durum Farina Grahamflour MaltRye Semolina Spelt(aformofwheat) Triticale Wheat • • • • • • • • • • • 12.2.ReadLabels Packagedfoodsshouldbeavoidedunlessthey'relabeledas gluten-freeorhavenogluten-containingingredients.Inaddition tocereals,pastasandbakedgoods—suchasbreads,cakes,pies andcookies—otherpackagedfoodsthatmaycontaingluten include: •Beer

  14. •Candies •Gravies •Imitationmeatsorseafood •Processedluncheonmeats •Saladdressingsandsauces,includingsoysauce •Self-bastingpoultry •Soups Certaingrains,suchasoats,canbecontaminatedwithwheat duringgrowingandprocessing.Pureoatsarenotharmfulfor mostpeoplewithceliacdisease.IntheUnitedStates,doctors generallyrecommendavoidingoatsunlesstheyhavebeen specificallylabeledgluten-free.OutsideoftheUnitedStates, differentlabelinglawsforoatsapply.Occasionally,evenpure oatscanbeaproblemforpeoplewithceliacdisease. 12.3. AllowedFoods Manybasicfoodsareallowedinagluten-freediet,including: •Freshmeats,fishandpoultrythataren'tbreaded,batter- coatedormarinated •Fruits •Mostdairyproducts •Potatoes •Vegetables •Wineanddistilledliquors,cidersandspirits Grainsandstarchesallowedinagluten-freedietinclude: •Amaranth

  15. •Arrowroot •Buckwheat •Corn •Cornmeal •Gluten-freeflours(rice,soy,corn,potato,bean) •Purecorntortillas •Quinoa •Rice •Tapioca Carobisapotentialsubstituteforgluten,butmoreresearchis neededaboutitseffectonpeoplewithceliacdisease. Fortunatelyforbreadandpastaloverswithceliacdisease,an increasingnumberofgluten-freeproductsareavailable.Ifyou can'tfindanyatyourlocalbakeryorgrocerystore,checkonline. Therearegluten-freesubstitutesformanygluten-containing foods.However,beawarethatprocessedgluten-freefoodsmay containexcessivefatandcalories. 13. AlternativeMedicine Therearenoproventreatmentsthatassistwithceliacdisease. Enzymetherapiesthatclaimtodigestglutenmaybeavailable inhealthfoodstoresorotheroutlets,butthereisnoscientific evidencethattheyareeffectiveintreatingceliacdisease. 14. CopingAndSupport

  16. Itcanbedifficult,andstressful,tofollowacompletelygluten-free diet.Herearesomewaystohelpyoucopeandtofeelmoreincontrol. Geteducated:Educatethosearoundyou—includingfamilyand friends—sotheycanrecognize,acknowledgeandsupportyoureffortsindealingwiththedisease. Followyourdoctor'srecommendations:Ifyouarediagnosed withceliacdisease,it'snecessarytomaintainatotallygluten-freediet. Findasupportgroup:It'shelpfultoknowthatyou'renot alone.Youmayfindcomfortinsharingyourexperienceand strugglesandmeetingpeoplewhofacesimilarchallenges. OrganizationssuchastheCeliacDiseaseFoundation,Gluten IntoleranceGroup,theCeliacSupportAssociationandBeyond Celiaccanhelpputyouintouchwithotherswhohavehadsimilar experiencesandcanunderstandwhatyou'regoingthrough. 14.1.PreparingForYourAppointment Youmaybereferredtoadoctorwhotreatsdigestivediseases (gastroenterologist). Here'ssomeinformationtohelpyouprepareforyour appointmentandknowwhattoexpectfromyourdoctor. 14.2. WhatCanYouDo

  17. Continueeatinganormaldiet.Ifyoustoporreduceeating glutenbeforeyou'retestedforceliacdisease,youmaychangethetestresults. Writedownyoursymptoms.Includewhentheystartedandhow theymayhavechangedovertime. Writedownkeypersonalinformation.Includeanymajorstresses orrecentlifechanges. Makealistofallmedications.Includevitaminsorsupplements thatyou'retaking. Writedownquestionstoaskyourdoctor. Questionstoaskyourdoctor Somebasicquestionstoaskyourdoctorinclude: What'sthemostlikelycauseofmysymptoms? Ismyconditiontemporaryorlongterm? WhatkindsoftestsdoIneed? Whattreatmentscanhelp? ArethereanydietaryrestrictionsthatIneedtofollow? HowwillIlearnwhichfoodscontaingluten?ShouldIseea dietitian? IfIhaveceliacdisease,willyoualsotestforotherconditions suchasvitaminormineraldeficiencies,osteoporosisordiabetes? Don'thesitatetoaskotherquestionsduringyourappointment.

  18. 14.3.WhatToExpectFromYourDoctor Bereadytoanswerquestionsyourdoctormayask: Whendidyoufirstbeginexperiencingsymptoms,andhowsevere arethey? Haveyoursymptomsbeencontinuousoroccasional? What,ifanything,seemstoimproveyoursymptoms? What,ifanything,seemstoworsenyoursymptoms? Whatmedicationsandpainrelieversdoyoutake? Doesanyoneinyourfamilyhaveceliacdisease? Doyouordoesanyoneinyourfamilyhaveanautoimmune disorder? Haveyouhadanyblisteringoritchyskinrasheswithyour symptoms? Haveyoueverbeendiagnosedwithanemiaorosteoporosis? 15. MythsAboutCoeliacDisease ‘Coeliacdiseaseisrare’...myth Researchshowsthatcoeliacdiseaseaffects1in100peopleinthe UK,makingitmuchmorecommonthanpreviouslythought. Underdiagnosisisabigproblemandresearchsuggestsaround 500,000peoplehavenotyetbeendiagnosed. ‘Coeliacdiseaseisafoodallergy’...myth

  19. Coeliacdiseaseisnotafoodallergyoranintolerance,itisan autoimmunedisease.Incoeliacdisease,eatingglutencausesthe liningofthesmallintestinetobecomedamaged.Otherpartsof thebodymaybeaffected. ‘Youhavetohavegutsymptomssuchasdiarrhoeatohave coeliacdisease’...myth Coeliacdiseaseisknownasa'multi-system'disorder-symptoms canaffectanyareaofthebody.Symptomsdifferbetween individualsintermsoftypeandseverity.Readmoreon symptomsifcoeliacdisease. ‘Onlychildrengetcoeliacdisease’...myth Coeliacdiseasecandevelopandbediagnosedatanyage.Itmay developafterweaningontocerealsthatcontaingluten,inoldage oranytimeinbetween.Coeliacdiseaseismostfrequently diagnosedinpeopleaged40-60yearsold.Delayeddiagnosisis commonandourresearchshowstheaveragetimeittakestobe diagnosedis13years. 'Youhavetobeunderweighttohaveundiagnosedcoeliac disease’...myth Recentresearchsuggeststhatmostpeoplewithcoeliacdisease areofnormalweightoroverweightatdiagnosis.Bodyweight aloneshouldnotbeusedtodecidewhetherornotyoushouldbe testedforcoeliacdisease.

  20. ‘Youcan‘growout’ofhavingcoeliacdisease’...myth Coeliacdiseaseisalifelongcondition.Thegluten-freedietisthe onlytreatmentforcoeliacdisease.Ifglutenisintroducedback intothedietatalaterdate,theimmunesystemwillreactandthe gutliningwillbecomedamagedagain.Ifsomeonefollowinga gluten-freedietisretestedforcoeliacdisease(antibodyblood test,gutbiopsy)itwouldbeexpectedthatthetestsarenegative. Thismeanstheyarerespondingwelltothegluten-freediet. Therearenoantibodiesinthebloodbecausethereisnogluten fortheimmunesystemtoreactagainst.Takingglutenoutofthe dietallowstheguttoheal. ‘Abreadcrumbwon’thurtsomeonewithcoeliacdisease’...myth Evenverysmallamountsofglutencanbedamagingtopeople withcoeliacdisease.Therefore,takingsensiblestepstoavoidcrosscontaminationwithglutenisimportant. 16. TopTips keepcookingutensilsseparateduringfoodpreparationand cooking avoidfryingfoodinthesameoilthathaspreviouslybeenusedto cookfoodswhichcontaingluten useacleangrill,separatetoasterortoasterbagstomakegluten- freetoast useseparatebreadboardsandwashsurfacesthoroughly

  21. useseparatecondimentslikejam,butter,mustardand mayonnaise. ‘CoeliacdiseaseonlyaffectspeopleofEuropeanorigin’...myth CoeliacdiseaseaffectsallethnicgroupsandiscommoninEurope andNorthAmerica,aswellasinsouthernAsia,theMiddleEast,NorthAfricaandSouthAmerica. 17.References 1.https://www.mayoclinic.org/ 2.https://www.coeliac.org.uk

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