Celiac disease affects the small intestines. When one has a celiac disease there is allergic reaction in the small intestines towards gluten that is commonly found in wheat, barley and oats. This immunological reaction results in an inflammation that destroys the inner lining of the small intestines (Fasano & Troncone, 2008). This eventually reduces the absorption of important nutrients into the body leading to symptoms of mineral and vitamin deficiencies. Celiac disease is also referred to as non-tropical sprue or gluten enteropathy
Celiac disease is mostly common in European countries such as Sweden, Italy and Ireland. United States has also indicated a high prevalence rate in Celiac disease though the symptoms of this disease are only visible in the late stages of life.
The allergic reaction toward gluten in the small intestines causes inflammation that completely destroys the little intestines. Evidence has shown of which this reaction is partly inherited and genetic. This means that around 11% associated with first degree relatives regarding persons with celiac condition have high chances associated with obtaining the disease (Fasano & Troncone, 2008). Similarly, around 35% of cordial twins, and 65% associated with identical twins have higher chances of both the twin babies having the disease. Right now there are also some certain genes that are just available with people with celiac disease
Gluten is usually a type of proteins which is present in wheat and consists of some protein called gliadin that dissolves in alcohol. The immunological reaction common in celiac disease is due to the gliadin. Upon the response, gliadin becomes toxic and damages the inner lining from the small intestines. Proteins such as gliadin are formed simply by long chains of proteins that are attached in order to each other. The digestive system enzymes present in the small intestines break proteins directly into smaller chains of proteins for facilitation of less difficult absorption (Thompson, 2006).
The allergic reaction in the small intestines can be because gliadin is usually not completely broken down simply by the intestinal enzymes leading to some long chains of amino acids to continue to be unbroken. These chains sink into the cells at the inner intestines and hence evoking the damage to the digestive tract cells. One of the longer chains in the amino acids attaches to typically the tissue transglutaminase. In persons with celiac disease, this particular combination causes an immune system reaction that destroys the particular intestinal cells. Foods that contain gliadin-like proteins these kinds of as barley and rye end up causing celiac disease in persons who else are genetically predisposed (Thompson, 2006). Oats contain gliadin that cause weak swelling and only attacks number of individuals who are predisposed to obtain celiac disease. Corn and rice do zero cause celiac disease due to the fact they lack gliadin-like proteins.
Effects inside the Small Intestinal tract
The inner liner of small intestines offers finger-like projections known since villi. They increase the surface area for intake of nutrients to the blood vessels stream (Blummer, 2010). The presence regarding celiac disease destroys the particular villi through inflammation building the inner lining regarding the small intestine to be flattened. When the villi are destroyed, it qualified prospects to mal-absorption of vitamins that eventually leads in order to nutrients’ deficiencies, an ailment known as malnutrition.
Typically the extent of the damage at the small intestinal tract varies from patient to individual and determines the degree of the signs and symptoms of the celiac condition. If all the little are affected by the inflammation, after that the patient is certain to have rigorous regarding mal-absorption.
Signs and Symptoms
The symptoms for celiac disease range from mild to more advanced signs (Fasano & Troncone, 2008). There generally two sets of signs and symptoms namely; symptoms due to mal-absorption and symptoms due to mal-nutrition of vitamins and minerals.
Signs and Symptoms of Mal-absorption
Celiac disease reduces the absorption of crucial nutrients such as carbohydrates, fats and proteins. Absorption of fat is affected more than the other nutrients and hence most of the gastrointestinal symptoms of celiac disease are caused by the inadequate absorption of fat or fat mal-absorption. Some of these symptoms include diarrhea, flatulence, abdominal bloating and high amounts of aft in the stool (steatorrhea) (Blummer, 2010). Diarrhea occurs when the unabsorbed fats are broken down into fatty acids by the intestinal bacteria. The fatty acids enhance the secretion of water into the intestine and hence resulting into diarrhea. The fatty stools are voluminous and have foul smell, are greasy and light grey in color and have tendencies of floating in the toilet bowl. Sometimes oil droplets from undigested fats may be spotted floating on water.
Mal-absorption of carbohydrates and especially sugar lactose that is common in milk is experienced by patients suffering from celiac disease. Lactose consists of glucose and galactose and has to split into these sugars for it to be absorbed in the body (Thompson, 2006). Lactase, which is the enzyme responsible for splitting glucose and galactose, is situated on the surface of the small intestinal villi. The damage of the intestinal wall due to inflammation causes mal-absorption of lactose in patients suffering from celiac disease. Symptoms of lactose mal-absorption include diarrhea, flatulence (passing of gas), pain in the abdomen and bloating. These symptoms are as a result of the unabsorped lactose passing into the colon where it is split into galactose and glucose by the bacteria present in the colon. Gases released by the bacteria are hydrogen and methane and are responsible for the flatulence. Increased gas in the stool also cause the floating of the stool in the toilet bowl.
Signs and Symptoms of Mal-nutrition
Some of the symptoms for nutrient deficiency include; loss of weight, fluid retention, anemia, bruising easily, peripheral neuropathy or nerve damage, osteoporosis, infertility and general muscle weakness. Weight loss is caused by the mal-absorption of fats, proteins and carbohydrates. Celiac disease causes increased appetite in the patients and therefore weight loss does not always occur. Protein is responsible of preventing fluid from leaking out of blood vessels and hence the reduction in protein levels causes fluid to leak into many tissues (edema) such as ankles and feet causing swelling of the same (Thompson, 2006). Easy bruising is caused by mal-absorption of vitamin K leading to lack of blood clotting. Nerve damage is caused is caused by the deficiency of thiamine and vitamins B12, and may lead to poor balance, muscle weakness and numbness. Infertility normally occurs in women when the celiac disease is untreated. Muscle weakness is caused by low levels of magnesium and potassium.
How Celiac Disease is diagnosed
Symptoms associate with celiac disease may also be experienced in patients with other diseases such as Crohn’s disease and pancreatic problems (Blummer, 2010). It is therefore important to carry out necessary testing to confirm celiac disease. Some of the recommended tests include small intestinal biopsy and specific antibody tests. Blood tests may also be performed to check vitamin deficiencies.
Treatment of Celiac Disease
There is no known cure for celiac disease and therefore gluten free diet is used as a form of treatment (Thompson, 2006). Foods made from rye, barley and wheat should be avoided completely. Some tablets that might contain gluten should also be avoided by persons with celiac disease.
Drugs for Celiac Disease Treatment
Drugs used for the treatment of celiac disease are mostly food supplements for replacing nutrients that are lacking in the body (Fasano & Troncone, 2008). Some of the drugs include; Dapsone, Effexor, Levaquin, Nexium, Prozac, Probiotics, Synthroid, Protonix and many more.