Celiac disease (CD) is a genetically linked disease with an environmental trigger. Celiac disease is an autoimmune digestive disease that damages the villi of the small intestine and interferes with absorption of nutrients from food. In people with CD, eating certain types of protein fractions, commonly called gluten, set off an autoimmune response that causes damage to the small intestine. This, in turn, causes the small intestine to lose the ability to absorb the nutrients found in food, leading to malnutrition and a variety of other complications.
The offending protein, gluten, is found in wheat, barley, rye, and to a lesser extent oats. Related proteins are found in triticale, spelt, and kamut.
The only known cure for Celiac Disease is 100% abstention from products containing gluten and the implementation of a Gluten-Free Diet. When gluten is removed from the diet, most of the damage that was done to the small intestine is repaired. Within three to six months, most symptoms subside as the mucosa returns to its normal or nearly normal state.
The Damaging Gluten Proteins
The term "gluten" is, in a sense, a generic term for the storage proteins that are found in grains. In reality, each type of protein - gliadin in wheat, secalin in rye, hordein in barley, avenin in oats, zein in corn and oryzenin in rice - is slightly different from the others. The "gluten" in wheat, rye, barley, and in a much lower amount, oats, contains particular amino acid sequences that are harmful to persons with celiac disease. The damaging proteins are particularly rich in proline and glutamine (especially the amino acid sequences which are in the following orders: Pro-Ser-Gln-Gln and Gln-Gln-Gln-Pro). As peptides, some such as 33-MER, cannot be broken down any further. In people with celiac disease, 33-MER stimulates T-cells to produce antibodies. The antibodies, in turn, attack the villi in the small intestine, reducing their ability to absorb nutrients. It is important to note that these sequences are NOT found in the proteins of corn and rice. (Celiac Sprue Association)
There are more than 300 symptoms of celiac disease, and symptoms may vary amongst different people. One person might have symptoms of diarrhea and abdominal pain, while another person has irritability or depression. Some patients develop celiac symptoms early in life, while others feel healthy far into adulthood. Some people with celiac disease may not show any symptoms.
Common symptoms of Celiac Disease can include - not all Celiac's display these symptoms, but any of them can be an indicator to warrant further test.
| Collapsed lumbar vertebrae |
Muscle cramping, Especially in the hands and leg |
Skin -Very dry |
|
Flatus - Passing gas
|
Decreased ability to clot blood |
Back pain |
| Night blindness |
Reduced fat padding of the feet |
Dehydration |
| Gluten ataxia |
Abdominal cramping & bloating |
Acidosis |
| Abnormal Appetite - craving |
Mouth sores or cracks in the corners |
Constipation |
| Depression |
Unable to concentrate |
Mood changes |
| Irritable |
Disinterested in normal activities |
Anemia |
Treatment of Celiac Disease
A number of tests, sometimes collectively referred to as the Celiac Blood Panel or Cascade, will aid the physician in diagnosis. The tests may include, but are not limited to:
- Serologic Tests
1. EMA (Immunoglobulin A anti-endomysium antibodies)
2. AGA (IgA anti-gliadin antibodies) Some people do not produce IgA antibodies.
3. DGP (Deamidated gliadin peptide antibody)
4. tTGA (IgA anti-tissue transglutaminase)
-
Tolerance or Measure of Digestion/Absorption Tests
1. Lactose tolerance test.
2. D-Xylose test.
Deamidated gliadin peptide (DGP) antibodies tests developed in 2007 in combination with Tissue transglutaminase (TTG) antibodies and have better accuracy than native gliadin antibodies. Multiplex immunoassay (MIA) measures multiple antibodies simultaneously providing with reduced turnaround time and cost. Combination testing identifies patients who are candidates for an intestinal biopsy. Test panels include AGA to determine if a person's body makes sufficient IgA antibodies for the EMA and TTG results to be reliable. IgA deficiency is, in itself harmless.(Source Celiac Spruce Association)
It is reported that as many 95% of Celiacs go undiagnosed or misdiagnosed with other conditions.
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