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Definition of Celiac Disease

Celiac disease is an autoimmune illness of the small intestine. It affects the digestive system when food containing gluten is ingested. Gluten is found in foods like barley, rye and wheat. For someone with celiac, the body’s immune response to gluten causes inflammation in the small intestine, damaging the lining. This reduces the intestine’s ability to absorb dietary nutrients. Symptoms caused by nutritional, vitamin, and mineral deficiencies can occur. A person suffering from celiac disease can become malnourished regardless of how much food is consumed.

Celiac disease is also known as sprue, nontropical sprue, gluten enteropathy, and adult celiac disease.

Celiac disease occurs in populations around the world, but it is more common amongst European and Scandinavian nations, particularly Ireland, Italy, Austria, Sweden, and Finland. One in three hundred people in Northern Ireland have it. In Finland one in one hundred are affected. In North America the rate is lower, at about one in three thousand. But, a recent study found that the United States has a rate of occurrence similar to that in Europe. The drawback to these studies is that people with celiac disease often go undiagnosed due to a lack of symptoms, or the symptoms occur later in life. Occurrence rates could actually be higher.

Symptoms of Celiac Disease

The typical symptoms of celiac disease may vary from person to person. Though the disease attacks or affects the digestive system or the small intestine, the symptoms may occur in any other part of the body. Celiac disease affects adults, children and even infants. In the case of infants and young children celiac disease affects the digestive system only.

Your body relies on three different types of nutrients: carbohydrates, protein, and fat. These nutrients are absorbed by the body through the intestines. When the intestines are not able to absorb as many nutrients as the body needs it is called malabsorption. Celiac disease causes malabsorption. Fat is usually the most affected by celiac disease. Your body gets rid of the fat it is not able to absorb. Fat malabsorption causes symptoms like diarrhea, foul smelling flatulence, abdominal bloating, and fat in the stool (steatorrhea).

The general symptoms of celiac disease in children and infants are:

• Vomiting
• Constipation
• Weight loss
• Delayed growth
• Abdominal bloating with pain
• Foul smelling and pale fatty stool
• Chronic diarrhea
• Irritability

If a child demonstrates some of these symptoms they may have celiac disease. Children with celiac disease may suffer from delayed growth resulting from malnutrition, delayed puberty, and dental problems.

In adults the symptoms of celiac disease may not start in the digestive system. Some of the symptoms observed in adults are:

• Bone loss or osteoporosis, especially in women
• Mysterious iron deficiency in blood causing anemia
• Itchy numbness in the hands and feet
• Bone or joint pain
• Fatigue
• Arthritis
• Depression and anxiety
• Infertility and recurrent miscarriage
• An itchy and/or painful skin rash known as dermatitis herpetiformis
• Seizures
• Recurring abdominal bloating and pain
• Chronic diarrhea
• Weight loss
• Pale, foul-smelling stool
• Gas
• Behavior changes
• Muscle cramps
• Pale sores inside the mouth, called aphthus ulcers
• Tooth discoloration or loss of enamel
• Missed menstrual periods (often because of excessive weight loss)

Symptoms due to malnutrition and vitamin or mineral deficiencies include:

• Weight loss and fluid retention: Celiac disease prevents the intestines from absorbing proper amounts of fat, protein, and carbohydrates. This affects the body in a few ways. Unexplained weight loss can occur. In cases where this leads to malnutrition a patient may begin retaining fluids. This is the body’s response to low protein levels in the blood. Proper protein levels in the blood enable the blood vessels to contain their fluid. When low protein levels occur, fluid leaks out of the blood vessels and is absorbed by the surrounding body tissue, particularly in the ankles and feet. This is known as edema. Patients can also experience a large increase in appetite as the body tries to make up for the nutrients it is not getting.
• Anemia: Because the body may not be able to absorb what it needs of vitamin B12 and iron, anemia can occur.
• Osteoporosis: Because the body may not be able to absorb what it needs of vitamin D and calcium there is an increased risk of osteoporosis and bone fractures.
• Bruising and bleeding: Vitamin K helps the blood to clot. If the body is not able to absorb enough of vitamin K the blood’s ability to clot may diminish, resulting in easy bruising or excessive bleeding.
• Peripheral neuropathy (nerve damage): Vitamin B12 and thiamine help keep the nerves healthy. If not enough is absorbed nerve damage can occur. Symptoms of nerve damage are poor balance, muscle weakness, and numbness and tingling in the arms and legs.
• Infertility: If a woman does not get enough nutrients she may experience a lack of menses (menstruation), have spontaneous abortions because her body doesn’t have enough nutrition to spare for the fetus, or give birth to a child with a low birth weight.
• Muscle weakness: Muscles need potassium and magnesium to maintain strength. Low levels of these minerals can lead to severe muscle weakness, muscle cramps, and numbness or tingling sensations in the arms and legs.

There have been cases where the patient showed none of the symptoms of celiac disease but suffered from it for a long time. If left untreated celiac disease may eventually lead to severe liver diseases or intestinal cancer. Sometimes people suffering from celiac disease have no gastrointestinal symptoms at all. Statistics say out of one hundred patients with celiac disease just a little over ten percent shows the classical obvious symptoms of malnutrition such as diarrhea, weight loss, and various other nutritional deficiencies. Some patients suffering from celiac disease do not show any regular symptoms of the disease and thus do not get properly treated. Celiac disease is often misdiagnosed, delaying treatment.

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