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CELIAC DISEASE BY EMER BYRNE. Koiliakos (greek) = abdominal Endemic Spure (chronic form of mal-absorption syndrome) Gluten Enteropathy Non-tropical Spure. CHARACTERISTICS. Autoimmune Disease (delayed allergy) (Triggered; surgery, pregnancy, viral infection) Small Bowl
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CELIAC DISEASEBY EMER BYRNE • Koiliakos (greek) = abdominal • Endemic Spure (chronic form of mal-absorption syndrome) • Gluten Enteropathy • Non-tropical Spure
CHARACTERISTICS • Autoimmune Disease (delayed allergy) (Triggered; surgery, pregnancy, viral infection) • Small Bowl • Reaction to Gliadin [gly-eh-din] (Gluten protein found in Wheat) • Children (9-24mts) – Bowl symptoms • Adults – Malabsorption related problems
PATHOLOGY • Exposure to Gliadin • Enzyme Tissue Transglutaminase modifies • Cross-reaction with bowl tissue • Inflammatory reaction • Flattening in villi • Interfering in absorption of nutrients
SYMPTOMS • Fatigue • Chronic Diarrhea • Failure to thrive (children) • Weight loss (adults) • Malabsorption related symptoms - Anemia (fe def, and megaloblastic) - Vit. K def - Osteopenia (Ca and Vit D def)
COMPLICATIONS • Lymphoma • Adenocarcinoma • Osteoporosis • Ulcerative jejunitis and stricturing (ulcers and narrowing)
FOODS TO AVOID • All foods containing wheat, barely, rye and oats - bread, pasta, cereals and beer • Artificial flavourings and colourings • Crisps and sweets • Vitamins, Medicines • Specific spirits • Stamp and Envelope adhesives
DIAGNOSIS • Blood tests - IgA - Anti EMA ( Endomysium) - Anti TTg ( Tissue Transglutaminase) • Endoscopy ( Gold standard)
ENDOSCOPY • Upper GI Endoscopy - EGD ( esophagogastroduodenoscopy ) • Visual examination of upper GI • Lighted, flexible fibro-optic or video scope • 15-30 mins • Outpatient procedure • No pain
TREATMENT • Lifelong gluten-free diet - Potato - Rice - Unprocessed; meat, fish, fruit and vegetables - Wine - Rum and Tequila
GLUTEN-FREE FOODS • Most foods are now available in gluten-free
PROGNOSIS • Intestinal damage begins to heal within weeks
WHY NOW?? • Glutens; very cheap and tasty - used more and more in unprocessed foods - larger profits for food manufactories • Water soluble gliadin = Problem - fine grinding, baking, fermenting, chemical treatment and synthesis
EPIDEMIOLOGY • 1% of Indo-Europeans; - Celtics - Balts - Germanic Peoples - Latins - Slavs • Prevalence - 1/300 Ireland - 1/133 America (3 million)
REFERENCES • http://www.celiac.org/ • http://www.celiac.nih.gov/ • http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/ • http://www.csaceliacs.org/ • http://www.glutenfreeoats.com/