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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/