CELIAC DISEASEBY EMER BYRNE

Koiliakos (greek) = abdominal Endemic Spure (chronic form of mal-

absorption syndrome) Gluten Enteropathy Non-tropical Spure

CHARACTERISTICS Autoimmune Disease (delayed allergy)

(Triggered; surgery, pregnancy, viral infection) Small Bowl Reaction to Gliadin [gly-eh-din]

(Gluten protein found in Wheat) Children (9-24mts) – Bowl symptoms Adults – Malabsorption related problems

PATHOLOGY Exposure to Gliadin Enzyme Tissue Transglutaminase modifies Cross-reaction with bowl tissue Inflammatory reaction Flattening in villi Interfering in absorption of nutrients

SYMPTOMS

Fatigue Chronic Diarrhea Failure to thrive (children) Weight loss (adults) Malabsorption related symptoms

- Anemia (fe def, and megaloblastic)

- Vit. K def

- Osteopenia (Ca and Vit D def)

COMPLICATIONS

Lymphoma Adenocarcinoma Osteoporosis Ulcerative jejunitis and stricturing

(ulcers and narrowing)

FOODS TO AVOID

All foods containing wheat, barely, rye and oats

- bread, pasta, cereals and beer Artificial flavourings and colourings Crisps and sweets Vitamins, Medicines Specific spirits Stamp and Envelope adhesives

DIAGNOSIS

Blood tests

- IgA

- Anti EMA ( Endomysium)

- Anti TTg ( Tissue Transglutaminase) Endoscopy ( Gold standard)

ENDOSCOPY Upper GI Endoscopy

- EGD ( esophagogastroduodenoscopy ) Visual examination of upper GI Lighted, flexible fibro-optic or video scope 15-30 mins Outpatient procedure No pain

Pathologic Duodenum Normal Duodenum

TREATMENT

Lifelong gluten-free diet

- Potato

- Rice

- Unprocessed; meat, fish, fruit and vegetables

- Wine

- Rum and Tequila

GLUTEN-FREE FOODS

Most foods are now available in gluten-free

PROGNOSIS

• Intestinal damage begins to heal within weeks

WHY NOW??

Glutens; very cheap and tasty

- used more and more in unprocessed foods

- larger profits for food manufactories Water soluble gliadin = Problem

- fine grinding, baking, fermenting, chemical treatment and synthesis

EPIDEMIOLOGY

1% of Indo-Europeans; - Celtics - Balts - Germanic Peoples - Latins - Slavs Prevalence - 1/300 Ireland - 1/133 America (3 million)

THANK YOU FOR YOUR ATTENTION

REFERENCES

http://www.celiac.org/ http://www.celiac.nih.gov/ http://digestive.niddk.nih.gov/ddiseases/

pubs/celiac/ http://www.csaceliacs.org/ http://www.glutenfreeoats.com/