Sunday 14 August 2011

Celiac Disease: Symptoms and Treatment


Celiac Disease: Symptoms and Treatment
Coeliac disease or celiac disease refers to a condition triggered by an autoimmune disorder within the small intestine. The condition is mostly observed in genetically predisposed people. Celiac disease does not exclude any age group and could manifest infancy onwards...

Small Intestine:

The small intestine is a vital body organ and part of the important gastrointestinal tract that follows the stomach and ends in the large intestine, parts of the digestive system. This passage is primarily responsible for most food digestion and absorption. The small intestine is contrary to the epithet 'small' and actually longer than the large intestine. The term relates more to the diameter than length. The organ is divided into the duodenum, jejunum and ileum. Most of the chemical digestion of ingested food nutrients takes place in the small intestine. The digestive enzymes that act on ingested food within this region are actually produced within the pancreas. They are then directed to the small intestine through the connected pancreatic duct, in response to the cholecystokinin hormone.

Digested food passes into the blood via a process called absorption. The inner wall of the small intestine, also called the mucosa, is lined with epithelial tissue in folds called plicae circulares. These folds have microscopic finger-like projections called villi. Villi help to increase the surface area available for the absorption of nutrients within the organ that otherwise has a small diameter. The villi comprises a network of capillaries and lymphatic lacteals that help to transport nutrients to the capillaries. Then, the absorbed substances are transported to different body organs via the blood vessels. There they are used to build proteins, as required by the body. This assimilation is contrary to the excretion of undigested and unabsorbed food.

Celiac Disease:

Celiac disease is the result of a reaction to gliadin. This gluten protein is mainly found in wheat, barley and rye. Exposure to this protein triggers an action by the enzyme tissue transglutaminase. The action culminates in protein modification and a reaction within the body's immune system. The affected small bowel tissue causes inflammation and in time, flattens the inner lining of the small intestine. This process is clinically referred to as villous atrophy and it severely interferes with vital nutrient absorption. Celiac disease can only be cured, or rather contained, with the help of a gluten-free diet. This condition is not to be mistaken for a wheat allergy.

History of Celiac Disease:

Celiac disease is also referred to as non-tropical sprue, endemic sprue, gluten intolerance, gluten enteropathy and gluten-sensitive enteropathy. The term was coined in the 19th century and is derived from the Greek name for 'abdominal'. The earliest record of the disease was made by Aretaeus of Cappadocia, in the second century. His work was only interpreted and made available for further analysis in 1856, by Francis Adams, at the Sydenham Society. It was noted paediatrician Samuel Gee who gave the world the modern-day description of celiac disease, in 1887. In 1908, the American physician Christian Archibald Herter, elaborated on the condition that he called 'intestinal infantilism'. The relationship between celiac disease, gluten intolerance and carbohydrates was established in the 1940s, by Willem Dicke.

Symptoms:

The symptoms of Celiac disease include:
Chronic diarrhea.
Fatigue.
Weight loss.
Stunted growth in children.
Irritable bowel syndrome.
Iron deficiency anemia.
Abdominal pain and distension.
Mouth ulcers.
Lactose intolerance.
Constipation.
Megaloblastic anaemia.
Osteopenia and/or osteoporosis.
Autoimmune disease.
Dermatitis herpetiformis.
Epilepsy.
Peripheral neuropathy.
Schizophrenia.
Miscarriage and infertility.
Diabetes mellitus type 1.
Autoimmune thyroiditis.
Celiac Disease Treatment:

The diagnosis of celiac disease is conducted with the help of endoscopy, serological blood tests, gastroscopy, biopsy, HLA genetic typing, DXA / DEXA scanning and classic pathology classification. It is only after a thorough confirmation of the condition that the treatment options are adopted. They include a gluten-free diet, the administration of immunosuppressants like azathioprine and enzyme combination.
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