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Celiac Disease; General Information

SOURCE: Canadian Celiac Association http://www.celiac.ca/celiac.php

Celiac Disease (CD)

Definition
Celiac disease is a medical condition in which the absorptive surface of the small intestine is damaged by a substance called gluten. This results in an inability of the body to absorb nutrients: protein, fat, carbohydrates, vitamins and minerals, which are necessary for good health.

Although statistics are not readily available, it is estimated that 1 in 133 persons in Canada are affected by celiac disease.

A wide range of symptoms may be present. Symptoms may appear together or singularly in children or adults. In general, the symptoms of untreated celiac disease indicate the presence of malabsorption due to the damaged small intestine.

Gluten is a protein found in wheat, rye, triticale, barley. In the case of wheat, gliadin has been isolated as the toxic fraction. It is the gluten in the flour that helps bread and other baked goods bind and prevents crumbling. This feature has made gluten widely used in the production of many processed and packaged foods.

At present there is no cure, but celiac disease is readily treated by following the gluten-free diet.

Recent studies have shown that pure uncontaminated oats may be used in the gluten-free diet with care. Please see the Professional Advisory Board statement re oats.

Symptoms
Common symptoms are anemia, chronic diarrhea, weight loss, fatigue, cramps and bloating, irritability.

Although some or all of these symptoms occur in celiac disease, some can also occur in many other diseases more common than celiac disease.

In other cases, sufferers from gluten-intolerance develop an intense burning and itching rash called dermatitis herpetiformis. The intestinal symptoms of celiac disease may or may not appear in dermatitis herpetiformis.

Diagnosis
a) Screening
Until recently physicians had to rely on clinical signs to suggest the diagnosis and to select which patients should have further investigation to prove the diagnosis. Since these signs may be vague or of varying severity this may be difficult. Now simple blood screening tests are becoming available to help this process.

b) Biopsy
A definitive diagnosis can only be made by a small bowel biopsy. The biopsy is performed by a specialist in the gastrointestinal field. The biopsy must be done before treatment is started.
Recommendations by International Celiac Societies and Associations regarding diagnosis of celiac disease as researched by Dr. Mohsin Rashid, Professional Advisory Board of CCA.

Treatment
Celiac disease as yet has no known cure, but can usually be effectively treated and controlled. The treatment of celiac disease is strict adherence to a GLUTEN FREE DIET FOR LIFE. This requires knowledgeable dietetic counselling and frequent "up-dates" as commercial food contents change.

Celiacs must be alert to hidden sources of gluten such as HVP/HPP (hydrolyzed vegetable/plant protein); malt; spelt; kamut; and certain drug products.

Today's processed and packaged foods have many hidden sources of gluten which can be unintentionally ingested. Particular care should be taken in the selection of soups, luncheon meats and sausages.

The person with celiac disease MUST READ THE LIST OF INGREDIENTS ON ALL LABELS, EVERY TIME.

There is a great variation in sensitivity to gluten among those with celiac disease, and although one may have no obvious symptoms, damage to the intestinal lining may still occur.

Related Diseases and Conditions
Celiac disease is an autoimmune disorder with a genetic component, appearing to be linked to certain types of HLA genes. There are a number of other diseases that are autoimmune-mediated and appear to have similar genetic linkages.

Type 1 diabetes
Sarcoidosis
Sjogren's syndrome
Grave's disease
Myasthenia gravis
These diseases are all autoimmune disorders which appear to have a higher incidence among people with celiac disease than in the general population. Treatment for CD will not cure these conditions.

Other Conditions: A number of other conditions have been reported that may occur because of untreated CD, and can be expected to improve when treated with a gluten-free diet.

Osteoporosis is a frequent complication of CD due to malabsorption prior to diagnosis. Adherence to a gluten-free diet can lead to significant bone remineralization. The two major determining factors in developing osteoporosis are maturation of peak bone mass and subsequent bone loss. Thus in order to achieve optimal bone mass, early detection of CD is essential.

Depression is another well-documented presentation of untreated or undiagnosed CD. Psychological improvement is usually noted after placement on a gluten-free diet and vitamin B6 treatments. Anemia, deficiency of iron, folic acid and/or Vitamin B12 is another common symptom of CD, and can be expected to improve on a gluten-free diet.

For more information, please visit this recipes web page.
This recipe was published on Thursday 29 September, 2011.








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