PRESENTED BYPRIYANKA SINGH

Celiac disease

Celiac disease

digestive and autoimmune disorder the lining of the small intestine affected  celiac sprue or gluten-sensitive enteropathy 

Cause

Prevalence

1% global population affected (Japan south-east Asia exception)

Irish/European or Western disease North Indian population most affected (Punjab, Haryana,

Delhi, Uttar Pradesh, Maharashtra, Rajasthan, Bihar, Uttaranchal, Madhya Pradesh and Gujarat.)

Prevalence rate of celiac disease has been doublingevery 20 years.

The diagnosis rate of celiac disease, only about 5%.

People at risk

RELATIVES OF INDIVIDUALS WITH CELIAC DISEASE (first degree relative more affected)

PEOPLE WITH OTHER AUTOIMMUNE CONDITION (type 1 diabetes , thyroid disorders)

PEOPLE WITH OTHER GENETIC CONDITIONS (down syndrome , tuner syndrome)

Symptom

Multi symptom multi organ disorder More than 200 sign and symptom Children exhibit classical symptom (gastrointestinal) Symptoms are atypical in adults (extra – intestinal)

Symptoms in children and infants

abdominal bloating and pain chronic diarrhea vomiting constipation pale, foul-smelling, or fatty stool weight loss fatigue irritability and behavioral issues dental enamel defects of the permanent teeth delayed growth and puberty short stature failure to thrive Attention Deficit Hyperactivity Disorder (ADHD)

Symptoms in adults

unexplained iron-deficiency anemiafatiguebone or joint painarthritisosteoporosis or osteopenia (bone loss) liver and biliary tract disorders peripheral neuropathy ( tingling, numbness or pain in the

hands and feet)seizures or migrainesmissed menstrual periods infertility or recurrent miscarriagecanker sores inside the mouthdermatitis herpetiformis (itchy skin rash)

Associated medical conditions

Health problems : Osteoporosis Miscarriage or infertility. Birth defects (neural tube defects) Seizures Growth problems Cancer of the intestine (very rare).

Autoimmune diseases: Thyroid disease Type 1 diabetes Lupus Rheumatoid arthritis Sjögren's syndrome 

Diagnosis

Blood test * tTG-IgA antibody (tissue transglutaminase

antibody) * total serum IgAt

* Anti-endomysial tests (EMA) * Anti gliadin IgA and Anti- gliadin IgG

antibody tests * Genetic tests – Genetic tests determine the

presence of gene HLADQ2 or HLA DQ8 in an individual Endoscopic biopsy gluten intake 8-12 weeks prior to biopsyConfirmation by positive attitude to gluten free diet

Treatment

No cureNo medicinal treatmentGluten free diet

Treatment and follow up

Treatment Strict gluten free diet Nutrition supplement for deficiencies (6-12 months after

diagnosis)

Follow up Follow up visits at 2 week, 3 month , 6month annually Refer to gluten free health cards Biopsy in special conditions

LIVING GLUTEN FREE

WHAT IS GLUTEN ?

storage protein three grains – wheat, barley and rye maintain shape, acting as a glue that holds food together

Going gluten free

Gluten can be present in a foodproduct in many ways:*As an ingredient *As additives or as a processing aid*Due to cross – contamination

20 parts per million, i.e. 20 mg of gluten per kg of food, is the generally

accepted limit of gluten in ‘gluten free’ labeled food items

In real life terms, approximately 1/10000th of a bread slice contains more gluten than this safe limit

The big three

Wheat is commonly found in: breads baked goods soups pasta

cereals sauces salad dressings

Barley is commonly found in: malt food coloring soups beer Brewer’s Yeast     Rye is commonly found in rye bread cereals

Other grains

Triticale breads pasta cereals

Oats

What can they eat?

Fruits Vegetables Meat and poultryFish seafoods Dairy Beans, legumes, and nuts

What about grains?

Rice Cassava Corn (maize)                                                 SoyPotato Tapioca Beans Sorghum Quinoa Millet Buckwheat groats Arrowroot Amaranth Teff Flax Chia Yucca Gluten-free oats Nut flours

REFERENCES

www.google.comwww.celiac.orgwww.celiacindia.org.inhttp://www.webmd.com/digestive-disorders/celiac-disease/celiac-disease