Celiac Disease Rachel Kinzie, Dietetic Intern 2011
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CELIAC DISEASERACHEL KINZIE, DIETETIC INTERN 2011
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Outline
What is it?
Symptoms
Who Does it Affect?
What is going on in the body?
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What is it?
People with celiac disease cannot tolerate a protein called GLUTEN, found in wheat, rye, and barley
A digestive disease that interferes with absorption of nutrients from food.
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Who Does it Affect?
It affects 1 in 133 people in the U.S. It is Genetic
Because of the genetic component, it is found in 5 to 15 % of siblings and offspring of celiacs.
It affects both children and adults
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Who Does it Affect?
Sometimes it is triggered for the first time after surgery, pregnancy, child birth, or severe emotional stress.
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Where Celiac Disease Targets
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Symptoms
Flatulence Constipation Bloating Indigestion Steatorrhea Abdominal pain*note that many newly diagnosed persons
with celiac disease report no gastrointestinal symptom
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How Do Symptoms Differ With Age?
In the past, celiac disease was considered to be a disease primarily of infants and children.
It is now clear that the initial signs and symptoms of celiac disease can occur in adults and even in the elderly.
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How Do Symptoms Differ With Age?
Infants/Children Steatorrhea, abdominal cramps, abdominal
distension, short stature (children), failure to thrive (infants)
Adults May have classic symptoms, but many either
have no symptoms or vague abdominal discomfort
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What is Celiac Disease is Not
It is NOT an allergy
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Allergic Reaction
AA
aaa
Allergen
• Histamines Released• Allergy Symptoms…
•Rash•Itchy/watery eyes•Difficulty breathing•Sometimes…
Abd. crampsVomitting Diarrhea
•Antihistamines can help with symptoms
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What Causes Celiac Disease?
Intolerance to Glutenan autoimmune
disorder
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Autoimmune Disorder (Celiac)
A A
aaa
Gluten
•Body attacks itself
•Antihistamines will NOT help
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The Small Intestine
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What Does the Small Intestine Do?
Tiny fingerlike projections called “villi” allow nutrients from food to be absorbed into the bloodstream.
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What Happens w/ Celiac Disease?
When people with Celiac disease eat Gluten, their body responds by damaging the small intestine.
The villi become damaged or destroyed.
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Long Term Effects
Malabsorption resulting in deficiencies… Calcium Vitamin D Iron Folate
Anemia Bone Disease Nerve Damage Muscle Weakness Cancer
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Long Term Effects
Joint Pain Anxiety Delayed Puberty Miscarriage Short Stature Easy Bruising Wt loss Fluid Retention Intestinal bloating or “potbelly”
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Related Complications
Those with CD are more likely to have other autoimmune disorders
Rheumatoid arthritis
Type I Diabetes
Autoimmune Thyroid Disease
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Related Complications
CD is often misdiagnosed as Irritable Bowel Syndrome In a survey of CD respondents, 37% reported
that they were initially diagnosed with IBS
Dermetitis Hepetiformis (DH) Manifestation of gluten sensitivity involving
the skin Can lead to itchy, blistering skin rash
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Related Complications
Lactose Intolerance Some people with CD aren't able to tolerate
milk sugar (lactose) found in dairy products.
Intestinal damage from consuming gluten Follow lactose and gluten free diet Once intestines have healed, you may be able
to tolerate dairy products again.
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What Should I Do if I Think I have Celiac Disease?
See your doctor http://www.celiaccentral.org/
“Celiac Symptoms Checklist” Symptoms of celiac disease are similar to many other conditions Small intestine biopsy Antibody test
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What is the Treatment for Celiac Disease?
A 100% Gluten Free Diet Speak with a dietitian about this as well
as the possible need for a multivitamin (Iron, B-vitamins, Fiber)
There is currently no cure
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Myth or Fact?
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Myth or Fact?
People with celiac disease are allergic to wheat?
Myth Celiac disease is an autoimmune
disorder, not an allergy. Celiac disease is often confused for an allergic illness because (like an allergy) it requires a foreign substance to trigger it.
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Myth or Fact?
If I have a normal weight, I am well nourished
Myth It is very possible to be overweight
and malnourished. Calories do not always = Nutrients.
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Myth or Fact?
Untreated Celiac disease can be life threatening
Fact
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Myth or Fact?
You can outgrow celiac disease Myth You can’t “outgrow” celiac disease-even
though doctors once thought you could. If you’re an adult who “had celiac disease as a child” you still have it now, even if the obvious symptoms have gone away.
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Is There Anything Else?
You are more likely to have celiac disease if a close relative has it.
Fact There is a genetic component to CD
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Myth or Fact?
Celiac disease is the same thing as Gluten Intolerance
Myth: Gluten intolerance is a broad term which includes all kinds of sensitivity to Gluten. However, if you have celiac disease, you have gluten intolerance.
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Myth or Fact?
Gluten can be absorbed through the skin
Myth Gluten molecules are too large to be
absorbed through the skin. Skin care products are okay
Just don’t swallow Toothpaste, lipsticks, lip balms, and
any product that will be used on small children should be gluten-free
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Myth or Fact
Celiac disease is linked to other autoimmune disorders, such as Type I Diabetes.
Fact: It is estimated between 1 in 20 people with type 1 diabetes also have CD.
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Myth or Fact
If you think you have celiac disease, you should begin a gluten free diet
Myth: You should NOT begin the gluten-free diet before you are diagnosed. Starting the diet will affect testing for the disease.
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Myth or Fact
You’ll feel better as soon as you stop eating gluten
Myth: The amount of time it takes to feel better after going gluten-free is different for every person. Some people feel the results right away, but other need weeks or months to feel results.
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Questions?
VIDEO - Celiac Disease: A Life of Misdiagnosis