COELIAC DISEASE

Coeliac disease

Table of Contents

Introduction1

Causes2

Symptoms3

Diagnosis of Coeliac disease5

Serology6

Histopathology7

Immunohistochemistry7

Saliva Test8

Treatment8

Conclusion10

References12

Coeliac disease

Introduction

Coeliac disease (CD), also spelled “Celiac” (also called by such names as gluten sensitive enteropathy, celiac sprue, and gluten intolerance) is a digestive disease that adversely affects both children and adults when they eat foods that contain the protein gluten. The inability of some people to digest gluten altogether is the reason behind celiac disease (Barton and Murray 2008). Although it resembles a food allergy, celiac disease is not one. Instead, it is an autoimmune disease (an adverse reaction of antibodies within the body) of the small intestine. The primary difference between the two conditions is that people sometimes resolve their food allergies, but people with celiac disease will not outgrow it (Barton and Murray 2008). They will always be intolerant to gluten.

The Coeliac Disease Foundation states that, around 1 of 133 people in the United States are affected with CD. Moreover, a person is at an increased risk (about 5-10%) when an immediate family member has celiac disease (Presutti, Cangemi, Cassidy and Hill 2007). Without proper diagnosis and treatment of the disease, people with celiac disease may develop medical complications such as cancer or osteoporosis. Celiac disease is genetic, meaning it runs in families. Sometimes the disease is triggered or becomes active for the first time after surgery, pregnancy, childbirth, viral infection, or severe emotional stress (Presutti, Cangemi, Cassidy and Hill 2007).

Causes

Celiac disease results from the intolerance to gluten. Actually called gliadin, gluten is found in certain grains, such as all types of barley, rye, triticale, and wheat. Gluten is an ingredient in many common foods, such as bread, pizza, pasta, breakfast cereal, cakes and cookies, and beverages such as beer. However, it is also contained in less common products such as certain vitamins and medicines (Presutti, Cangemi, Cassidy and Hill 2007).

When digested, gluten is modified so the body's immune system reacts abnormally to it in the intestines, creating a toxic (inflammatory) reaction, which interferes with the absorption of nutrients such as vitamins and minerals (Presutti, Cangemi, Cassidy and Hill 2007). The digestive system is unable to absorb the necessary nutrients. Even small amounts of ingested gluten cause health problems and can eventually flatten the lining of the small intestine. This flattening, which is called villous atrophy, damages the small intestine, reducing the ability of the body to absorb nutrients (mal-absorption) (Presutti, Cangemi, Cassidy and Hill 2007).

The small intestine is compromised because the modified gluten damages, and sometimes destroys, millions of microscopic-sized, finger-tip-like protrusions called villi, which line it (Drago, Di Pierro, Catassi and Fasano 2002). Under normal conditions, the villi allow nutrients to be absorbed through the walls of the small intestine and into the bloodstream. However, individuals with celiac disease do not obtain all of these nutrients, so they become mal-nourished, regardless of the quantity or quality of food they eat (Drago, Di Pierro, Catassi and Fasano 2002).

The risk of developing celiac disease may be genetically determined. Africans and Asians are less likely to get celiac disease, and ...