Celiac

Celiac disease (also spelled coeliac disease) is an autoimmune disorder that primarily affects the small intestine. It occurs in genetically predisposed individuals and is triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. The disease can lead to various gastrointestinal and extra-intestinal symptoms and complications.

Pathophysiology

Celiac disease is characterized by an inappropriate immune response to gluten, leading to inflammation and damage to the villi of the small intestine. This damage impairs nutrient absorption, which can result in malnutrition and a variety of associated health issues. The primary immune response involves T cells and the production of autoantibodies such as anti-tissue transglutaminase (tTG) and anti-endomysial antibodies (EMA).

Symptoms

Symptoms of celiac disease can vary widely and may include:

• Diarrhea
• Abdominal pain
• Bloating
• Weight loss
• Fatigue
• Anemia
• Dermatitis herpetiformis (a skin rash)

In some cases, individuals may be asymptomatic or have atypical symptoms, making diagnosis challenging.

Diagnosis

Diagnosis of celiac disease typically involves a combination of serological tests and a small intestine biopsy. Common serological tests include:

• Anti-tissue transglutaminase (tTG) antibodies
• Anti-endomysial antibodies (EMA)
• Deamidated gliadin peptide (DGP) antibodies

A biopsy of the small intestine, obtained via endoscopy, is used to confirm the diagnosis by demonstrating villous atrophy and crypt hyperplasia.

Treatment

The only effective treatment for celiac disease is a strict, lifelong gluten-free diet. This involves the complete avoidance of foods containing wheat, barley, and rye. Adherence to a gluten-free diet can lead to the healing of the intestinal mucosa and resolution of symptoms. Regular follow-up with a healthcare provider and a dietitian experienced in managing celiac disease is recommended.

Complications

If left untreated, celiac disease can lead to several complications, including:

• Osteoporosis
• Infertility
• Neurological disorders
• Intestinal lymphoma
• Other autoimmune disorders

Epidemiology

Celiac disease affects approximately 1% of the global population, with higher prevalence in certain regions such as Europe and North America. It can occur at any age, although it is often diagnosed in childhood or early adulthood.

Related Pages

• Autoimmune disorder
• Gluten
• Small intestine
• Dermatitis herpetiformis
• Gluten-free diet
• Malnutrition
• Endoscopy