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CELIAC DISEASE

CELIAC DISEASE. Joanne Nugent M.S., R.D, L.D., CDE. Celiac Disease. An inflammatory disease of the small bowel initiated by gluten. Leading to malabsorption of nutrients and effect all systems of the body. Celiac disease. Autoimmune disease;intolerance to gluten Gluten sensitive

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CELIAC DISEASE

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  1. CELIAC DISEASE Joanne Nugent M.S., R.D, L.D., CDE

  2. Celiac Disease An inflammatory disease of the small bowel initiated by gluten. Leading to malabsorption of nutrients and effect all systems of the body

  3. Celiac disease • Autoimmune disease;intolerance to gluten • Gluten sensitive • Wheat allergy • 1 in 100 is the estimated prevalence of celiac disease. • Takes an average 11yr to get diagnosis • 35% exhibit chronic diarrhea • 2-3x more common in women • 97% of people with celiac have not been diagnosed

  4. Pathophysiology Villi are similar to shag carpet. Damage from gluten causes breakdown of villi. When villi atrophy, the shag carpet is more similar to a tile floor. “LEAKY GUT” This results in the inability to absorb certain nutrients(iron,calcium,vit.- D,A,E,K,protein and folic acid).

  5. GI symptoms Chronic diarrhea/constipation Abd pain/distention Poor appetite/intake Vomiting Non GI symptoms Dermatitis herpetiformis Dental enamel hypoplasia Osteopenia/osteoporosis Iron deficient anemia Delayed puberty Infertility Fatigue/irritability and failure to thrive SYMPTOMS

  6. Complications • Lymphoma • Intestinal carcinoma • Osteoporosis • Refractory Celiac disease

  7. Dermatitis herpetiformis T1DM Liver/Thyroid disease Lupus Addison’s disease Down’s/Sjogren’s syndromes Rheumatoid Arthritis Immune Disorders

  8. Treatment • Lifelong diet that is gluten free • Total elimination of wheat, rye, and barley

  9. Gluten??? • Gluten is an elastic protein found in certain grains. • Proteins that cause problems for celiac disease 1. Gliadin/wheat 2. Secalin/rye 3. Hordein/barley.

  10. Common Sources of Gluten • Pasta • Cereal • Bread, pizza crust, salad croutons • Crackers, pretzels • Cookies, cakes, pies, pastries • Beer • Cross contaminated oats/other food products

  11. Foods that MAY contain Gluten • Candy • Soy sauce • Lunch/processed meats • Rice mixes • Seasoned chips • Canned soups/sauces • Imitation fish • Communion wafers • Matzo/matzo meal

  12. Potential Sources • Chewing gum • Lipstich/balm • Personal care products; shampoo, lotions • Medications; prescription, OTC, herbal and vitamins and minerals

  13. Flours containing gluten • Bulgur • Couscous • Kamut • Semolina • Spelt • Graham flour • Triticale • Wheat germ

  14. Rice flours Almond flour Amaranth Arrowroot Buckwheat Corn flour-corn starch Cornmeal Gram flour(chick peas) Potato starch flour Quinoa Soy (soya flour) Tapioca starch Teff grain Potato flour Sorghum flour Gluten-free flours

  15. Gluten-Free Foods • Fruits • Vegetables • Milk, cream, most ice creams, cheese, cottage cheese, cream cheese • Potatoes, corn, rice, lentils, beans • Butter, margarine, oil, salad dressing (allowed ingredients) • Fresh meat, fish, poultry, eggs • Plain nuts, seeds, popcorn

  16. MORE Gluten-free • Tea, coffee, soda • Distilled alcoholic beverages • Plain pickles, olives, relish, ketchup, tomato paste, mustard (with distilled vinegar, herbs/spices, black pepper • Honey, jam, jelly, corn/maple syrup, sugar

  17. Labels • Food Allergen Labeling and Consumer Protection Act (FALCPA) • Food labels identify eight main food allergens (milk, eggs, panuts, tree nuts, fish, crustacean shellfish, soy and wheat • Gluten-free are wheat free, but wheat free are not always gluten free

  18. Compliance barriers • Cost • Availability • Taste/quality • Patients lack of symptoms • Difficulty with labeling of food/drugs • Poor education from healthcare providers

  19. www.celiac.com www.celiacsprue.com www.niddk.nih.gov/health/digest/pubs/celiac/index.htm www.glutenfree.com Support group cinciceliac.com Resources

  20. Bottom Line • Celiac disease can be managed successfully with education, resources and support.

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