Celiac Disease

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🌾 Celiac Disease

Celiac disease is a chronic autoimmune disorder where the ingestion of gluten (a protein found in wheat, barley, and rye) triggers an immune response that damages the small intestine lining, specifically the villi, which are essential for nutrient absorption.

🧬 Cause:

  • Triggered by gluten in genetically predisposed individuals
  • Associated with genes HLA-DQ2 and HLA-DQ8
  • Autoimmune reaction leads to villous atrophy in the small intestine

🩺 Symptoms:

🧒 In Children:

  • Chronic diarrhea or constipation
  • Abdominal pain and bloating
  • Failure to thrive or delayed growth
  • Irritability
  • Fatigue

👨‍🦰 In Adults:

  • Diarrhea, bloating, gas
  • Unexplained weight loss
  • Fatigue
  • Anemia (iron deficiency)
  • Bone or joint pain
  • Skin rash (dermatitis herpetiformis)
  • Infertility or menstrual irregularities
  • Numbness or tingling in hands/feet

🩻 Silent or Atypical Celiac Disease:

  • No obvious GI symptoms
  • May present with fatigue, osteoporosis, liver enzyme abnormalities, or neurological symptoms

🔍 Diagnosis:

  1. Blood tests:
    • tTG-IgA (Tissue Transglutaminase Antibody) – most common screening test
    • Total IgA (to check for IgA deficiency)
    • EMA (Endomysial antibodies)
    • DGP (Deamidated gliadin peptide antibodies)
  2. Small intestine biopsy (via endoscopy):
    • Confirms diagnosis by showing villous atrophy
  3. Genetic testing (optional):
    • HLA-DQ2/DQ8 gene presence supports diagnosis but isn’t diagnostic on its own

❗️Important: Tests must be done while still consuming gluten to avoid false negatives.

🍞 Treatment:

  • Strict lifelong gluten-free diet
    • Avoid wheat, barley, rye, and foods that contain them
    • Read labels carefully (gluten is in many processed foods)
  • Nutritional supplements if deficiencies are present
  • Regular follow-up for symptom monitoring and nutritional assessment

⚠️ Complications (if untreated):

  • Malnutrition and weight loss
  • Anemia
  • Osteoporosis
  • Infertility or miscarriage
  • Neurological disorders (e.g. ataxia, peripheral neuropathy)
  • Increased risk of intestinal lymphoma or small bowel cancer (rare)
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