Celiac disease

ARAVINTH MATHIYALAGAN GROUP # 6

Definition :

Celiac disease is an immune reaction to eating gluten.

If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction produces inflammation that damages the small intestine's lining and prevents absorption of some nutrients (malabsorption).

WHAT IS GLUTEN?

The portion of the protein in wheat, barley and rye that forms the structure of dough.

MECHANISM OF ACTION Body attacks normal tissue resulting in

damage to lining of small intestinal villi, the tiny hair like projections that line inside of small intestine. Villi contain blood vessels which absorb

nutrientsVilli increase area for absorption of nutrientsDigested nutrients are carried away by

circulating blood If villi are damaged, vitamins, minerals,

calcium, carbohydrates, protein, and fats are not absorbed well

Normal intestinal surgical specimen with distinct villi

Celiac disease specimen withtotal loss of villi, the arrowsindicate crypt openings

Who has celiac disease? 3 million Americans

97% un-diagnosed 1 in 133 have celiac disease More common than “Crohn’s disease, ulceric colitis

and cystic fibrosis combined” Commonly mis-diagnosed as Irritable Bowel

Syndrome, IBS

Relatives of celiac’s are much more likely to have celiac disease.

Diagnosis : Blood tests

Check for anti-body levels in the blood Called a “celiac panel”

Endoscopy and biopsy of the small intestine Final diagnosis based on biopsy before starting a

gluten-free diet Can be diagnosed even if there are no symptoms

Normal intestinal biopsy

Small intestinal biopsy in a patient with active celiac disease

Treatment : All food, cosmetics, bath products, medications must be

gluten-free

No wheat-based ingredients Not processed around wheat, barley, or rye

Contamination causes reaction Even small amounts of gluten in food will affect a celiac Contamination examples

eating a piece of fruit that was served on a plate which previously held bread

inhaling and swallowing air-borne wheat flour at a bakery

Management : Medical management Nutritional management

Electrolyte and fluid

replacement

Vitamin and mineral

supplementation

Calcium and vitamin D

administration

Delete gluten sources from

diet

Substitute with corn, rice,

potato, soya bean

Read food labels carefully for hidden gluten-containing

ingredients

Thank u !