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Celiac Disease

Celiac disease is an autoimmune disorder triggered by consuming gluten, a protein found in foods made from wheat, barley, and rye. In individuals with celiac disease, gluten consumption causes the immune system to attack the lining of the small intestine, leading to damage over time. This damage impairs the intestine's ability to absorb nutrients properly, resulting in malabsorption and related health complications.

Although there is no permanent cure, adopting a strict gluten-free diet can help manage symptoms and promote intestinal healing.

Causes

Genetic Factors
Family history of celiac disease or dermatitis herpetiformis increases the risk.
Gluten Consumption
Eating gluten-rich foods triggers the immune response.
Environmental Triggers
Surgery, pregnancy, childbirth, severe stress, or infections can activate the disease.
Gastrointestinal Factors
Altered gut bacteria or infections may contribute, though their role isn't fully established.

Symptoms

Digestive Symptoms:

  • Diarrhoea

  • Bloating and gas

  • Abdominal pain

  • Nausea and vomiting

  • Constipation

  • Weight loss

Non-Digestive Symptoms:

  • Iron-deficiency anaemia

  • Bone disorders (osteoporosis, osteomalacia)

  • Itchy, blistering skin rash (dermatitis herpetiformis)

  • Mouth ulcers

  • Fatigue, headaches, and joint pain

  • Numbness or tingling in hands and feet (peripheral neuropathy)

  • Impaired spleen function (hyposplenism)

Symptoms in Children:

  • Chronic diarrhoea or constipation

  • Bloated abdomen

  • Pale, foul-smelling stools

  • Growth delays, short stature, or failure to thrive

  • Delayed puberty

  • Tooth enamel damage

  • Behavioural issues or irritability

  • Neurological conditions like ADHD or seizures

Diagnosis

Blood tests: To detect specific antibodies linked to celiac disease (e.g., tTG-IgA).

Endoscopy and biopsy: A small intestine biopsy confirms the diagnosis by identifying intestinal damage.

Genetic testing: Identifies predisposition through HLA-DQ2 and HLA-DQ8 genes.

Gluten challenge: May be used if testing occurs after adopting a gluten-free diet to confirm the diagnosis.

Treatment

Gluten-free diet:

Avoiding gluten-containing foods is the only effective treatment. This includes eliminating products with wheat, barley, rye, and derivatives.

Nutritional supplements:

To address deficiencies (e.g., iron, calcium, vitamin D).

Monitoring and follow-ups:

Regular consultations to assess symptom improvement and monitor nutrient levels.

Dermatitis herpetiformis management:

A gluten-free diet and medications like dapsone are used to treat the skin condition.

Treatment of complications:

For issues like osteoporosis, anaemia, or neurological conditions, additional medical intervention may be required.

Conclusion

Celiac disease requires lifelong management through a gluten-free diet to alleviate symptoms, prevent complications, and promote intestinal healing. Early diagnosis is essential to avoid long-term issues such as malnutrition and osteoporosis. Regular monitoring by healthcare providers ensures optimal health and well-being for those with the condition.
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