Coeliac disease is a digestive
disease that damages the small intestine and interferes with
absorption of nutrients from food. People who have coeliac
disease cannot tolerate a protein called gluten, which is
found in wheat, rye, barley, etc. When they eat foods
containing gluten, their immune system responds by damaging
the small intestine. As the body's own immune system causes
the damage, coeliac disease is considered an autoimmune
disorder. However, it is also classified as a disease of
malabsorption because nutrients are not absorbed.
What is the cause?
The exact cause of coeliac disease is
unknown. There is evidence that the disorder is inherited
since it tends to run in families. The disorder may be
caused by an abnormal immune response to proteins found in
grains, particularly gluten and the related protein gliadin.
The intestines contain projections, called villi that
normally absorb nutrients. Coeliac disease causes these
villi to become flattened and lose the ability to absorb
nutrients. Sometimes the disease is triggered or becomes
active for the first time after surgery, pregnancy,
childbirth, viral infection, or severe emotional stress.
What are the symptoms?
The symptoms vary from person to person and,
therefore, can be quite confusing. Most people have the
symptoms outlined below. Occasionally, however, people with
this condition have no symptoms at all or have bulky stool,
even constipation, without weight loss or change in
appetite.
In infants and children:
Abnormal stools
Diarrhoea
Slow growth
Irritability
Bloody or clay-coloured, foul-smelling
stools
Vomiting
Weight loss
Decreased appetite (anorexia)
Muscles in arms and legs are thin and
wasted
Abdominal distention
In adults:
Abnormal appearance of the teeth
Abdominal distention
Abdominal pain
Bloating
Bone pain
Bone tenderness
Breathlessness due to anaemia
Depression
Diarrhoea
Fatigue
Irritability
Muscle cramps
Tiredness
Vomiting
Weight loss
Additional symptoms that may be associated
with this disease are nosebleed, overall swelling and
floating stools.
How is it diagnosed?
Typically, most people with coeliac disease
will have symptoms of malabsorption such as diarrhoea.
However, some will have bone disease, anaemia, or other
conditions without diarrhoea. Compression fractures of the
back, or other signs of bone disease may be present.
Dental examination may show changes in the
teeth. In fact, some cases of coeliac disease are suspected
by a dentist because of the changes in the enamel of the
teeth, which include symmetrical changes in the tooth colour
and surface texture.
A blood test often indicates anaemia. Two
relatively new blood tests have improved the ability to
accurately diagnose this disorder. Both, the IgA
antiendomysial antibody and the antigliadin antibodies are
sensitive and specific for the diagnosis of coeliac disease.
An endoscopy and small bowel biopsy,
particularly biopsy of the jejunum (the part of the small
intestine most often affected), will show an abnormal
intestinal lining. Serial biopsies may be performed before
and after a gluten-free diet. Improvement of the findings of
biopsy (or improvement of symptoms) after a gluten- and
gliadin-free diet is considered highly indicative of coeliac
disease.
What is the treatment?
A life-long gluten-free diet is
recommended. This allows the intestinal villi to heal.
Gluten-free diet:
Foods that contain wheat, rye, oats, and barley
must be eliminated from the diet. Hidden sources of gluten
include grain derivatives such as malt, modified food
starch, soy sauce (some types), grain vinegar, and some
binders, fillers, and flavourings should be avoided. Despite
these restrictions, people with coeliac disease can eat a
well-balanced diet with a variety of foods, including bread
and pasta. For example, instead of wheat flour, people can
use potato, rice, soy, or bean flour. Or, they can buy
gluten-free bread, pasta, and other products from special
food companies. Plain meat, fish, rice, fruits, and
vegetables do not contain gluten, so people with coeliac
disease can eat as much of these foods as they like.
The gluten-free diet is complicated. It requires a
completely new approach to eating that affects a person's
entire life. Eating out can be a challenge as the person
with coeliac disease learns to scrutinize the menu for foods
with gluten and about possible hidden sources of gluten.
Hidden sources of gluten include additives, preservatives,
and stabilisers found in processed food, medicines, and
mouthwash. A dietician, or a health care professional who
specializes in food and nutrition, can help people learn
about their new diet.
A small percentage of people with coeliac disease do not
improve on the gluten-free diet. These people often have
severely damaged intestines that cannot heal even after they
eliminate gluten from their diet. Because their intestines
are not absorbing enough nutrients, they may need to receive
intravenous nutrition supplements. Drug treatments are being
evaluated for unresponsive coeliac disease. These patients
may need to be evaluated for complications of the disease.
Vitamin and mineral supplements may be needed to correct
nutritional deficiencies. Sometimes, corticosteroids (such
as prednisone) may also be required. The stress of a chronic
disorder such as coeliac disease can sometimes be helped by
joining a support group where members share common
experiences and problems.
What is the prognosis?
Untreated, the disorder can
cause life-threatening complications. Symptoms usually
disappear within several weeks after the person begins a
gluten-free diet. The gluten-free diet must be followed
continuously or the symptoms will return.
Celiac Disease Symptoms
Healthcare Provider
Coeliac Diseases - treatment of Coeliac
Diseases, Coeliac Diseases types, Disease medicines, Coeliac Diseases
symptoms, Coeliac Diseases and Disease symptoms, Coeliac Diseases symptoms
Disease and diagnosis, Symptoms and Solutions, Signs and Symptoms, type of
Coeliac Diseases, cause common, common Coeliac Diseases, Coeliac Diseases
List, causes list, Infectious Coeliac Diseases, Causes, Diseases , Types,
Prevention, Treatment and Facts, Coeliac Diseases information, Coeliac
Diseases: Definition, Coeliac Diseases names, medical Coeliac Diseases,
medical Coeliac Diseases and disorders, cell Coeliac Diseases, Coeliac
Diseases Worldwide, Coeliac Diseases Research, Coeliac Diseases Control,
Coeliac Diseases Center, Digestive Coeliac Diseases Week, Information about
Coeliac Diseases, causes of different Coeliac Diseases, Coeliac Diseases
Articles, Coeliac Diseases and conditions, Health and Coeliac Diseases,
Coeliac Diseases Patients, Coeliac Diseases and Sciences, causes of
alzheimer's Coeliac Diseases, Coeliac Diseases causes, alternative medicine
heart Coeliac Diseases, body ailments, Coeliac Diseases medicines, medical
antiques, type of blood Coeliac Diseases