St Mary's Guardian Pharmacy


Celiac Disease

What is this that everyone is talking about?


FACTS
Celiac disease is also called celiac sprue, non-tropical sprue, and gluten-sensitive enteropathy. It is a hereditary condition in which a person has an allergic reaction delay to gluten (a protein that causes dough to be sticky) found in cereals such as oats, wheat, barley, and rye. This sensitivity damages the lining of the small intestine so that it can't absorb nutrients from food. Celiac disease affects approximately 0.5% to 1% of people in Canada. Recent research has revealed that, contrary to what was previously believed, celiac disease may be more common in places like Africa, South America, and Asia.

CAUSES
The lining of a normal small intestine is covered with finger-like projections called villi. The villi are covered with tiny hair-like endings called microvilli, which trap and absorb nutrients from food. In celiac disease, the villi flatten out or disappear due to the allergic response to eating foods containing gluten. The villi lose their shape and their microvilli, resulting in the damage to the intestinal lining.

SYMPTOMS
A person with celiac disease isn't able to absorb the nutrients from food. This problem of malabsorption can cause vitamin and mineral deficiencies. Iron deficiency from malaborption causes anemia, which is a reduction in red blood cells. This can lead to fatigue and tiredness. Symptoms of celiac disease can include serious diarrhea, bloating, and cramps.

The food that isn't absorbed is excreted in feces. Too much diarrhea can lead to severe dehydration. Bowel movements are often bulky, light tan or grey, and frothy or rancid-smelling because the stools contain fat that couldn't be absorbed. The feces often stick to the toilet bowl because of the large amount of fat in them.

People with celiac disease often lose weight because their bodies can't absorb the much-needed nutrients from the foods they eat. Lack of vitamins and minerals may lead to many different complications People who lack protein will have swollen legs. Lack of vitamin K causes bleeding gums. Some people's nerves will be affected and they may have trouble thinking or concentrating. Others may have dry skin or sore lips and tongue. Sometimes, people with celiac disease have osteomalacia (softening of bones) due to nutritional deficiencies.

DIAGNOSIS
To diagnose celiac disease, the doctor will conduct tests and ask about symptoms and their relationship to food. These tests usually include blood tests and an examination of your small intestine by taking a sample of the intestinal tissue. Blood tests look for certain antibodies that a person with celiac disease may produce in higher-than-normal amounts. These antibodies are a sign that the body is mistaking gluten for a foreign substance and trying to remove it from the body. Doctors insert a thin tube called an endoscope into the intestine. A tissue sample of the lining of the small intestine is taken to be examined under a microscope. The doctor then examines the cells to search for signs of celiac disease.

TREATMENT & PREVENTION
People with celiac disease must avoid eating gluten-containing foods. This means that they can't eat bread products made with wheat, rye or barley. Gluten is also found in many prepared foods such as pasta. People with celiac disease have to carefully check the labels on processed foods for gluten. They shouldn't buy any processed food unless they know exactly what's in it. They should also be careful to check if vitamins and medications they are taking contain any gluten. Fortunately, more and more gluten-free food options are becoming available.

Keeping the body hydrated is important. As well, taking vitamin and mineral supplements may be helpful to compensate for the problems of malabsorption. Once the person begins to follow the gluten-free diet, the bowel begins to heal and the problem of malabsorption may go away. It can be difficult to follow a truly gluten-free diet so it's important to make a definite diagnosis of celiac disease. If celiac disease is diagnosed, a gluten-free diet must be followed for the rest of the person's life.

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