Celiac disease has become more common in young people but is still not very well known. Celiac disease, is a inflammatory condition of the small intestine triggered by consuming the protein gluten (Schuppan, The Diagnosis and Treatment of Celiac Disease, 2013). Gluten is a general name for proteins found in wheat, rice, emmer, and rye. Those who have been diagnosed with celiac disease who eat food containing gluten will have an immune reaction in their small intestines which will causing damage to the inner surface of the small intestine and as a result they will be unable to absorb nutrients (Schuppan, The Diagnosis and Treatment of Celiac Disease, 2013).
The small intestine is made up of a long tube in the digestive system. It is responsible for absorbing up to 90% of the food and nutrients we consume. Thus, if it is damaged by an inner lining it leads to the small intestines having difficulty absorbing important nutrients; this problem commonly referred to as malabsorption. Although celiac disease cannot be cured, avoiding gluten will stops the damage to the intestinal lining and the malabsorption that results. This disease affects about 3 million American women, men, and children.
Pathology
There is not only one complete of having Celiac disease. What is typically associated with this disease can vary from individual. But, this disease is more common in Caucasian females (Dugdale III, Longstreth, & Zieve, 2010). It can also affect a person at any point in their life, even if they’re very young. In children it can start to occur when the child is taken off milk and started on solids (familydoctor.org editorial staff, 2010). When it is present in children it usually affects their growth. Those who had celiac in a young age often experience delayed puberty, poor weight gain, and shorter than normal height. (familydoctor.org editorial staff, 2010). It can also affect teeth and cause changes in the tooth’s color and the effects to gastrointestinal behaviors can cause diarrhea, nausea, and vomiting. Dugdale III, Longstreth, & Zieve, 2010).
Those who have developed Celiac as adults often experience the same as what the children experienced without the effects on puberty or growth. If they have a mild form of the disease they can have almost no symptoms and others could experience a loss or gain in appetite, abdominal pain, and indigestion. (The Mayo Clinic staff, 2011). If a person is experiencing malabsorption, a blood test can detect this issue because it will result in decreased iron absorption and vitamin deficiencies. These deficiencies can be very harmful because they can deprive other parts of the body such as the brain, peripheral nervous system, bones, liver and other organs that are important (Dugdale III, Longstreth, & Zieve, 2010).
There aren’t any exact cause of celiac disease that are known, but researchers have found that it is genetic (The Mayo Clinic Staff, 2011). There are other factors that have been noticed in those with celiac disease, researchers have seen that affected patients have a gene such as HLA-DQ2 or HLA-DQ8 and sensitive autoantibodies against the human enzyme transglutaminase (Schuppan, The Diagnosis and Treatment of Celiac Disease, 2013). Researchers have seen that in a person without celiac, normally the small intestines are lined with villi, which aid in the intake of vital nutrients from food one’s body needs to normally function (The Mayo Clinic Staff, 2011). In people with celiac disease, the villi are damaged which is the cause as to why the body is not be able to intake the nutrients needed (The Mayo Clinic Staff, 2011). Since the exact cause of the disease is not known researchers theorize that when people with celiac disease eat foods or use products that contain gluten, their immune system’s antibodies react by damaging these villi (The Mayo Clinic Staff, 2011). There are also theories that believe that celiac disease is also caused by environmental factors since it has been shown that people living in Europe, North and South Americas, Australia, North Africa, the Middle East and in South Asia are more likely to have Celiac disease than people from other parts of Asia or sub-Saharan Africa (Kelly & Dennis, Patient information: Celiac disease in adults, 2009).
Diagnosis and Development
Since the signs and symptoms are similar to other conditions, celiac disease is hard to diagnose. It is through testing that we are able to distinguish celiac disease from other intestinal disorders. As previously stated a blood test is useful because it can determine the blood level of antibodies (proteins) that increase in people with celiac disease. Those with untreated celiac disease have higher antibody levels, which can be used to differentiate from non celiac disease patients (Iqbal, 2008). It will be useful during treatment to monitor the levels of antibodies in the blood. If your levels decline on a gluten free diet, this indicates that the diet has been effective in treating the disease (Iqbal, 2008). Celiac disease may be latent, silent, or full blown. A positive IgA endomysial antibody test and/or a positive IgA-tTG test and a normal small bowel biopsy are characteristic of latent celiac disease (Kelly, Diagnosis of celiac disease, 2011). Latent disease does not require a gluten-free diet. However, blood test monitoring is recommended and a repeat biopsy may be needed if symptoms reoccur.
“A positive blood test for celiac disease and an abnormal small bowel biopsy, with no other symptoms of celiac disease is considered “silent” celiac disease” (Kelly & Dennis, Patient information: Celiac disease in adults, 2009).
For a person with any type of celiac disease, tests for malabsorption, such as iron, folic acid, or vitamin B12 and vitamin D levels, are necessary to be checked every year (Kelly & Dennis, Patient information: Celiac disease in adults, 2009). In addition, a bone density (DEXA) scan to measures bone density after beginning a gluten free diet is also recommended. Significant bone loss may require medication to stop bone loss and encourage new bone growth (Kelly & Dennis, Patient information: Celiac disease in adults, 2009).
Treatment
The most common way to treat Celiac disease is to eliminate gluten from your diet by avoiding foods that contain wheat, rye, barley, malt, and yeast (Horvath, 2009). The elimination of gluten from one’s diet is not an easy task and it takes research into the foods that one would normally have in their diet, planning, and very careful observation as to what is in food. Gluten is also hidden as an ingredient in a large number of prepared foods, as well as medications and supplements (Horvath, 2009). Gluten is found in foods that you would not even think of as having it. For example, some peanut or nut products contain gluten in them. So paying special attention to the labels on food is necessary. Elimination of gluten from ones diet is a life changing decision, but for a person with celiac disease, it is necessary to maintain good health.
Conclusion
An understanding of celiac disease, the causes and treatment, will allow people with a genetic sensitivity to gluten to manage their disease. Left untreated celiac disease can range from mild discomfort in some people to acute intestinal and skin problems in others. If a patient is willing to adhere to a strict diet that includes total elimination of gluten products from his/her diet, then an illness free life style is entirely possible. Knowledge of the disease and a willingness to eliminate gluten from ones diet will produce benefits worth the sacrifice.