Celiac disease (in short)
- Celiac (or coeliac) disease is a chronic intestinal disease caused by intolerance to gluten (a protein that is found in some cereals).
- It
is characterized by immune-mediated enteropathy (auto-immune disease), associated with maldigestion and
malabsorption of most nutrients and vitamins.
- In predisposed individuals, the ingestion
of gluten-containing food such as wheat barley, triticale and rye induces a flat jejunal mucosa with
infiltration of lymphocytes.
- The main symptoms are: stomach pain, gas, and bloating,
diarrhea, weight loss, anemia, edema, bone or joint pain.
- Frequency of celiac disease varies from 1:270 in Finland to 1:5000 in North America.
- Since
celiac disease can be asymptomatic (without any symptom), most subjects are not diagnosed or they can present
with atypical symptoms. Furthermore, severe inflammation of the small bowel can be
present without any gastrointestinal symptoms.
- The diagnosis should be made early
since celiac disease causes growth retardation in untreated children and atypical
symptoms like infertility or neurological symptoms.
- Diagnosis requires endoscopy with
jejunal biopsy.
- In addition, tissue-transglutaminase antibodies (blood sample) are important to confirm
the diagnosis since there are other diseases which can mimic celiac disease.
- The exact
cause of celiac disease is unknown but is thought to be primarily immune mediated
(tissue-transglutaminase autoantigen); often the disease is inherited.
- Management
consists in life long withdrawal of dietary gluten, which leads to significant clinical
and histological improvement. However, complete normalization of histology (the microscopic study of tissues) can take
years.