| General Illness Information |
Common Name: |
Celiac
Disease |
|
Medical Term:
|
Gluten
Enteropathy |
| Description: |
A chronic diarrheal disease
characterized by intestinal malabsorption of almost all nutrients
precipitated by eating foods containing gluten.
This intestinal sensitivity to gluten, a protein found in
wheat, barley, rye and oats causes changes in the intestine which
prevents it from absorbing nutrients.
Usually present between ages of 6-12 months when the child is
first introduced to gluten. However, in adults symptoms may
develop slowly over months or years.
Most forms of the disease are inherited and it is not
contagious. |
| Causes: |
Usually a congenital disorder with
sensitivity to gluten, a protein found in wheat and rye and to a
lesser degree in oats and barely.
In this condition, the gladding fraction of the gluten molecule
attaches to the antibodies in the small intestine, causing the
normal brush-like lining of the intestine to flatten. These
changes reduce the digesting and absorbing capability of the small
intestine. However, when gluten is eliminated from the diet, the
normal brush-like surface is restored and normal intestinal
function is restored. |
| Prevention: |
Unknown at present. |
| Signs
& Symptoms |
 |
Weight loss in an infant
after the introduction of cereal. |
|
Failure to thrive in an infant |
|
Poor appetite. |
|
Diarrhea with pale, bulky,
greasy, foul smelling stools. Diarrhea may be absent in 10%
of cases. |
|
Swollen abdomen. |
|
General undernourished
appearance. |
|
Anemia. |
|
Tiredness. |
|
Swollen legs. |
|
| Risk Factors |
|
Family history. First order
relatives -10% incidence; 71% in monozygotic twins |
|
Children with type I diabetes
mellitus. |
|
IgA deficiency. |
|
Down's Syndrome. |
|
| Diagnosis & Treatment |
Laboratory
tests includes blood tests, stool test for fecal fat, d-xylose
test for malabsorption and small bowel biopsy. .In celiac
disease, the blood test is positive for Anti-gliadin IgA and
IgG and anti-reticulum and anti-endomycial antibodies.
|
| General
Measures: |
|
Firm diagnosis is made by a biopsy, in
which a small sample of tissue is taken from the small
intestine. |
|
Only treatment is a
gluten-free diet. Rice, corn and soybean flour are good
substitutes. Gluten is present in most grains especially
wheat, rye and barley. |
|
| Medications: |
|
Iron and folic acid for anemia. |
|
Calcium and multiple-vitamin supplements
for deficiencies. |
|
Oral cortisone may hasten improvement but
is only in very severe attacks (undecided). |
|
| Activity: |
|
No restrictions. |
|
| Diet: |
|
Gluten-free diet. It is
difficult to exclude gluten from the diet completely, so be
patient while becoming familiar with the diet, which a
dietitian can help you plan. |
|
| Possible
Complications : |
|
|
|
|
|
| Prognosis |
| With a strict
gluten-free diet improvement occurs in 2-3 weeks. In rare
cases, gluten withdrawal does not bring immediate
improvement. These patients may respond to treatment with
corticosteroids.
A small percentage of adult patients with celiac disease
may develop a lymphoma in the intestine. It is not known if
adhering to a strict gluten-free diet diminishes the risk of
developing a lymphoma. |
|
| Other |
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