Celiac Disease

Description

Celiac disease is a chronic disorder that has a genetic component. When an individual with celiac disease ingests gluten, it triggers an immune response that damages the lining of the small intestine. The result is that certain nutrients cannot be absorbed properly.

What is gluten?

Gluten is a protein found in many grains including wheat, barley and rye. Since wheat flour is the most commonly used flour, foods such as bread, pasta and pastries are likely to contain gluten.
Gluten is not only found in food products. Certain medications and beauty care products also contain gluten.

Risk factors

Anyone can develop celiac disease. In fact, the prevalence of celiac disease in North America is close to 1%. In some individuals, it can develop in childhood, while in others, it can be triggered by stressful events (surgery, pregnancy, infection or intense emotional stress). Some are at greater risk for developing the disorder.

  • Women are 2 to 3 times more likely to develop celiac disease than men. Men however, tend to be more severely affected.
  • It is more common in Caucasians.
  • People with a relative who suffers from the disease is also more likely to develop celiac disease. About 10% of those with celiac disease have a close relative who also has the disease.
  • Individuals with type 1 diabetes, thyroid disorders or trisomy are also at greater risk.

Symptoms

Symptoms vary greatly. Some symptoms are typical gastrointestinal problems, while others are the result of nutritional malabsorption. It is good to know that the severity of symptoms is not related to the severity of the disease.

Common intestinal symptoms

  • Diarrhea
  • Abdominal distension

Symptoms related to poor absorption

  • Anemia
  • Fatty stools
  • Repeated spontaneous miscarriages
  • Growth delay, short height
  • Bloating

Other symptoms

  • Rashes
  • Tingling and numbness
  • Headache
  • Mouth ulcers
  • Joint pain
  • Fatigue
  • Muscle spasms

Complications

If left untreated, celiac disease can lead to numerous, more serious complications including:

  • The development of autoimmune disorders
  • Thyroid disorders
  • Cancer
  • Infertility
  • Osteoporosis

Diagnosis

A diagnosis of celiac diseases requires several steps. The disease is first suspected based on the patient's symptoms. Then, blood tests are used to measure the levels of certain antibodies. The key to confirming the diagnosis however, lies in an intestinal biopsy.

Treatment

Once celiac disease is confirmed with a biopsy, the patient must go on a strict gluten-free diet since it is the only way to avoid long-term complications associated with celiac disease. Individuals with the disorder must not only avoid foods that contain large amounts of grains, but must also avoid products that contain trace amounts since ingesting even a very small quantity of gluten is enough to cause damage. It is imperative that anyone diagnosed with celiac disease consult a dietician.

Improvement of symptoms is noticeable in the days and weeks after gluten is eliminated from the diet. Approximately 90% of those with celiac disease respond well to a gluten-free diet.

Since celiac disease is responsible for the malabsorption of several nutrients, blood tests and examinations must be performed to determine whether nutritional deficiencies are present. The nutrients most often affected are folic acid, vitamins A, B12, D, E and K, iron and calcium. Depending on the results, supplementation may be required to make up for the deficiencies.

If you have any questions, do not hesitate to speak to your pharmacist.

For more information or for support:

Canadian Celiac Association

www.celiac.ca

Fondation québécoise de la maladie coeliaque

www.fqmc.org

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