Celiac Disease

Celiac Disease

Celiac Disease
Celiac disease is an inherited, auto-immune disease affecting the lining of your small intestine. If you have celiac disease, it means that your body cannot process gluten, which is found in any food containing wheat, barley or rye. While symptoms vary from person to person, many patients will complain of gastrointestinal problems. Anemia is also a very common presenting symptom of celiac disease. A life-long gluten free diet is the standard of care for treating celiac disease.

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    If the results of the antibody or genetic tests for celiac disease are positive, your doctor may suggest an endoscopic biopsy. An endoscopy is a procedure that allows your doctor to see what is going on inside your gastrointestinal (GI) tract. While you are sedated, a scope is inserted through your mouth and down your esophagus, stomach and small intestine, giving the doctor a clear view and the option of taking a sample of the tissue.

    This is usually an outpatient procedure. Samples of the lining of your small intestine will be studied under a microscope to look for damage and inflammation due to celiac disease. It is recommended that the doctor take at least four samples in order to obtain an accurate diagnosis.

    For biopsy results to be accurate, you must be eating gluten (at least four slices of bread per day) for one to three months prior to the procedure. Check with your doctor to confirm this.
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    An endoscopic biopsy usually is necessary to confirm a celiac disease diagnosis -- but a skin biopsy can replace the need for this procedure if you have a condition called dermatitis herpetiformis (DH), which produces a skin rash.

    For people with DH, a skin biopsy is sufficient for the diagnosis of both DH and celiac disease. This biopsy involves collecting a small piece of skin near the rash and testing it for the IgA antibody. It is not necessary to perform an endoscopic biopsy to establish the diagnosis of celiac disease in a person with DH; the skin biopsy is definitive. 
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    A , Cardiology (Cardiovascular Disease), answered
    Because gluten is found in so many things, from food to beauty products, it can be hard maintaining a gluten-free lifestyle. Get familiar with the terms on this list, and make sure to check food items and products to ensure they are gluten-free before using or consuming them. While this is a comprehensive list, you may still want to call the company directly to get a complete list of ingredients, just to be safe.

    Gluten glossary:
    • amino peptide complex
    • amp-isostearoyl hydrolyzed wheat protein
    • avena sativa (oat) flour
    • avena sativa (oat) flour kernel
    • barley derived
    • barley extract
    • disodium wheatgermamido PEG-2 sulfosuccinateH
    • hordeum vulgare (barley) extract
    • hydrolyzed wheat gluten
    • hydrolyzed wheat protein
    • hydrolyzed wheat protein PG-propyl silanetriol
    • hydrolyzed wheat starch
    • hydroxpropyltrimonium hydrolyzed wheat protein
    • oat (avena sativa) extract
    • oat beta glucan
    • oat derived
    • oat extract
    • oat flour
    • phytophingosine extract
    • rye derived
    • sodium lauroyl oat amino acids
    • triticum vulgare (wheat) flour lipids
    • triticum vulgare (wheat) germ extract
    • triticum vulgare (wheat) germ oil
    • tocopherol
    • tocopheryl acetate
    • vitamin E (make sure it's not derived from wheat)
    • wheat (triticum vulgare) bran extract
    • wheat amino acids
    • wheat bran extract
    • wheat derived
    • wheat germ extracts
    • wheat germ glycerides
    • wheat germ oil
    • wheat germamidopropyldimonium hydroxypropyl hydrolyzed wheat protein
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    A , Administration, answered
    Celiac disease can not be prevented since it is a genetic disease.  It can be managed and symptoms can be controlled by following a strictly gluten free diet.  Gluten is found in wheat, barley, and rye products and oats are often contaminated as well.  Individuals diagnosed with Celiac disease can consult with a Registered Dietitian for guidance on following a gluten free diet.  
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    A , Internal Medicine, answered
    Dr. Robin Miller - celiac disease and asthma
    Sixty percent of people who have celiac disease also have asthma. In this video, Dr. Robin Miller explains the connection between the two conditions.

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    A , Internal Medicine, answered
    Celiac is woefully underdiagnosed, and millions are at risk for such complications as GERD (gastroesophageal reflux disease) and osteoporosis in adults, and anemia, abdominal pain, and growth deficiencies in children -- not to mention epilepsy and atrial fibrillation (irregular heartbeat).

    Celiac disease damages tiny villi lining the small intestines, which normally shuttle nutrients from food into the bloodstream. When they can't, you get nutritional deficiencies, diarrhea, cramping, vomiting, weight loss, even skin rashes.
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    Celiac disease is an autoimmune disorder in which the gluten you eat activates your immune system and results in damage to the villi in your small intestine. Villi are small, finger-like projections in the small intestines that help you absorb nutrients. Villous atrophy is the blunting or flattening of the villi, which can be caused by the damage done by the immune system in a person with celiac disease after they eat gluten.

    Damage to the villi can begin as early as three hours after exposure to gluten. However, the villi are not permanently damaged, as the intestines continuously renew themselves and can heal when you go on a gluten-free diet.

    Refractory celiac disease, also known as refractory sprue, affects up to 5% of people with celiac disease. For these people, the damaged villi in the small intestine do not heal from a gluten-free diet, and all other potential causes for this damage have been ruled out. These people are usually treated with steroids and immunosuppressants.
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    Celiac disease affects children differently than adults by causing different symptoms and distinct issues related to development. Children are much more likely than adults to exhibit symptoms that are related to their digestive tract. An enlarged abdomen, abnormal stools, vomiting, and trouble gaining weight or noticeable weight loss may be signs that a child has celiac disease. Children are uniquely affected given that they need the nutrients that their bodies are lacking to properly grow and develop. Children with celiac disease often appear malnourished, have stunted growth, development issues, late onset of puberty, and may even fail to thrive.

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    You should tell your child's school about their diagnosis of celiac disease and the gluten-free diet required for treatment. The school may need to make accommodations for your child's dietary needs in the cafeteria. Your child's teacher should be notified so they can make sure that school parties, fieldtrips, and after-school activities have a gluten-free option for your child.

    Depending on your child's age you may also need teachers and classroom helpers to take an active role in screening the food that is offered to your child. Don't be afraid to ask your child's doctor to talk to the school on your behalf, however, you will have to give permission for the doctor to talk about certain health information regarding your child.

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    Children cannot grow out of celiac disease because unlike many food allergies, it is a life long condition. It was once thought that celiac disease was similar to a wheat allergy. Wheat allergies, along with many food allergies in childhood, can be outgrown. If your child has celiac disease and is treated with a gluten-free diet, their small intestine should completely repair themselves in approximately six months. However, even with the damage repaired your child will always have intolerance to the protein gluten. A child affected by celiac disease can lead a healthy life as long as they manage their condition by eating a completely gluten-free diet.

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