Celiac Disease

Celiac Disease

Celiac disease, also known as gluten-sensitive enteropathy (as well as two older and less preferred terms, nontropical sprue and celiac sprue) is a multisystem disorder estimated to affect approximately 1% of Americans. It results from an inappropriate T-cell–mediated immune response to ingested gluten that causes inflammatory injury to the small intestine in genetically predisposed persons. Damage to the proximal small intestinal mucosa results in the malabsorption of nutrients. The average age of diagnosis is in the fifth decade of life but only an estimated 10% to 15% of persons with celiac disease in the United States have been diagnosed. The prevalence of celiac disease in the United States seems to have increased 4- to 5-fold over the past 3 to 4 decades. Disease manifestations are protean, and gastrointestinal symptoms are not always present. Virtually every body system can be affected, with dermatologic, hematologic, neurologic, musculoskeletal, endocrine, reproductive, and digestive systems most commonly involved. Moreover, celiac disease is associated with a variety of autoimmune conditions whose clinical course may be affected by the diagnosis and treatment of celiac disease. Although patients respond well to treatment with a gluten-free diet, unrecognized or untreated celiac disease is associated with both increased mortality. and risk for intestinal lymphoma.

Persons with celiac sprue experience improvement in the condition when on a strict, gluten-free diet and relapse when dietary gluten is reintroduced. With treatment,celiac sprueis rarely fatal.

If you have celiac disease and eat foods with gluten, your immune system responds by damaging the small intestine. Gluten is a protein in wheat, rye and barley. It is found mainly in foods but may also be in other products like medicines, vitamins and even the glue on stamps and envelopes.

Celiac disease affects each person differently. Symptoms may occur in the digestive system, or in other parts of the body. One person might have diarrhea and abdominal pain, while another person may be irritable or depressed. Irritability is one of the most common symptoms in children. Some people have no symptoms.

Celiac disease is genetic. Blood tests can help your doctor diagnose the disease. Your doctor may also need to examine a small piece of tissue from your small intestine. Treatment is a diet free of gluten.

Some signs and symptoms are due to malabsorption and malnutrition resulting from the disorder. It should also be noted that symptoms can vary greatly from person to person. Signs and symptoms associated with celiac disease can include:
Abdominal cramps, gas and bloating
Bone and joint pain
Depression
Diarrhea
Easy bruising
Failure to thrive in children
Flatulence (gas)
Fluid retention
Foul-smelling stools
Gastritis, gastrointestinal symptoms, including hemorrhage
General weakness, fatigue
Increased amount of fat in the stools
Infertility
Persistent hunger
Iron deficiency anemia
Irritability
Malnutrition
Mouth Sores
Muscle wasting, muscle weakness, muscle cramps
Nausea, vomiting
Nerve damage (tingling in the legs and feet)
Nose bleeding
Nutrient Deficiencies
Obesity
Osteoporosis
Panic Attacks
Red urine
Skin Rash
Stomach Discomfort, stomach rumbling
Unhealthy pale appearance
Vertigo
Vitamin B12, D, and K deficiencies
Weight Loss
A degree of lactose intolerance may develop
Dermatitis herpetiformis (rashes typically on the elbows, knees and buttocks)
Sometimes symptoms are not clear, and the patient just generally feels unwell

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