Celiac Disease: Symptoms, Causes and Treatment
What is Celiac Disease? Gluten-induced Enteropathy
Celiac Disease is a mal-absorption disease of the proximal small intestine, that is characterized by abnormal mucosa with permanent intolerance to gluten. eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine’s lining and prevents absorption of some nutrients.
Celiac disease isn’t the same thing as a food allergy, so the symptoms will differ. If you’re allergic to wheat, you may have itchy or watery eyes or a hard time breathing if you eat something that has wheat in it. But if you have celiac disease and accidentally eat something with gluten in it, you may have intestinal problems. The intestinal damage often causes diarrhea, fatigue, weight loss, and can lead to serious complications.
Etiology of Celiac Disease :
Altered physiology :
Characteristics of the disease include :
- Impaired intestinal absorption.
- Histological abnormalities of the small intestine.
- Clinical and histological improvement with the gluten-free diet.
- Recurrence of clinical manifestations and histological changes after reintroduction of dietary gluten.
Histological changes :
- Loss of normal villous pattern.
- Obliteration of intervillous spaces.
- Loss of epithelial cell brush border.
These changes result in disaccharide deficiency, inability to absorb fats, fat-soluble vitamins, minerals, and some proteins and carbohydrates.
Mal-absorption result from a decreased area of absorption.
Clinical manifestations :
- Diagnoses are most commonly made at 6-24 months of age ( it can be made in the adult.
- Chronic or recurrent diarrhea ( foul . bulky, and greasy stool).
- Anorexia, vomiting, abdominal distention, muscle wasting, and hypotonia.
- Weight loss and dehydration.
- Mood changes ( irritability and nervousness).
- Secondary deficiencies such as anemia , hypocalcaemia and hypoproteinemia .
Diagnostic evaluations :
- History and general status.
- Small bowel biopsy.
- D-xylose test ( less than 20-25mg/dl at 60 minute ) .
- Hb level.
- Stool test ( fecal fat excretion ).
- Sweet test ( to rule out cystic fibrosis).
- Lifelong gluten-free diet.
- Adequate caloric intake.
- Supplemental vitamins.
- Decreased fat intake.
Treatment of celiac crisis:-
- Restore fluid and electrolyte balance.
- Parenteral hyperalimentation.