celiac disease

Introduction

The celiac disease, also known as gluten enteropathy or celiac sprue is an autoimmune digestive disorder of the small intestines where an individual becomes gluten intolerant. Small intestines digest and absorb food and transfer the remains to the colon. In celiac disease, patients exhibit an immunological reaction to gluten in the small intestine linings causing inflammation and impairing the lining. When such individuals are into contact with the protein gluten, there are undesirable effects that manifest which includes and not limited to diarrhea, abdominal pain and bloating. These symptoms arise from the autoimmune reaction when the immune system recognizes gluten as foreign or pathogenic and attacks it, a reaction, which may impair the small intestines (MedicineNet pr. 1).  As a result, patients of celiac disease are unable to digest and absorb many nutrients from the diet such as other proteins, vitamins, carbohydrate, calcium and other minerals as well as fats which are essential for normal growth and functioning of the body. Gluten is a protein commonly found in rye, barley and wheat as well as their products such as bread, cakes, pasta and most breakfast cereals (Thompson 13). Celiac disease is genetic and most people inherit it from their parents although it may not manifest until there is an interaction with certain environmental factors such as stress, physical injury, surgery, some infections as well as childbirth. The disease was detected initially in the second century and in the twentieth century, its causative factors were determined (Fasano 1). Nowadays, people suffer from many health problems, such as celiac disease because of poor diets.

Causes

The impairment of the inner small intestine lining in patients of the celiac disease is attributed to the allergic reaction towards the protein gluten which causes inflammation. The reaction may be genetic where around ten percent of primary relatives of people with celiac disease are diagnosed with a similar condition. Moreover close to thirty percent of fraternal twins and seventy percent of identical ones indicates that both twins have the disorder. Besides, there are particular genes that have been noted in patients with celiac disease as compared to healthy ones. Gluten consists of complex proteins such as gliadin which is absorbed by alcohol. Gliadin is responsible for immunological reaction manifested in patients with celiac disease. In the process, gliadin turns toxic and impairs the lining. Gliadin is an extensive amino acids chain. In digestion process, enzymes present in small intestines separate protein into individual amino acid to be absorbed by the small intestines (MedicineNet pr. 3). However, gliadin does not fully segregate under enzymatic reaction to give out smaller amino acids. The long chains absorbed by the lining cells due to their permeability prove to be damaging to them.  The longer chains join a tissue transglutaminase enzyme where in patients with celiac disease, the complex trigger an immune reaction which attacks the complex and in turn harm the entire cell (Marsh 115). Rye, wheat and barley are rich in gliadin protein which may trigger celiac disease in those individuals who are predisposed genetically. Gliadin in oat cause weak inflammatory reaction and a lesser cause of the celiac disease in predisposed persons. On the other hand, corn or rice is not a causative factor of celiac disease since they lack gliadin proteins (Medicinenet pr. 4 & 6).

Symptoms

The small intestines have fingerlike protrusions known as villi responsible for increasing the surface area for absorption. In celiac disease, the villi are impaired in a process called villous atrophy and the lining becomes flat which lessens the surface area for nutrients absorption. This causes malabsorption hence malnutrition (Fasano 89). The extent of damage depends on the patient and this establishes the symptoms severity. Total loss of villi has malabsorption problems hence, severe symptoms as compared to patients’ whose damage is partial. Celiac disease severity may be attributed to many factors such as breastfeeding durations, the age of exposure to gluten and the content of gluten consumed by a particular person (MedicineNet pr. 8).

The celiac disease manifests in different ways which may include the following; severe symptoms include steatorrhoea or loose, greasy & pale excrement, loss of weight and stranded growth in children. In some instances, there may lack symptoms whatsoever in patients with the celiac disease infants with the condition may have digestive symptoms e.g. constipation, abdominal pain, diarrhea and vomiting, which may affect their growth and inability to increase weight. This may cause a child to become irritable, over dependent and may marginalize himself from others. In case of malnourishment, a child experience weak muscular growth, enlarged tummy as well as flat buttocks. Besides, teenagers may have a late puberty, alopecia aeata or hair loss and may even have dental problems (Crowe & Blumer 93). Moreover, adults may not experience digestive symptoms but may experience poor health accompanied by feelings such as fatigue, joint/bone pains, stress, become anxious and amenorrhea in females. Celiac disease may cause osteoporosis characterized by bone pains since calcium is not properly absorbed in the body. There may be lactose intolerance in celiac patients, where they are unable to digest milk and its products. Finally, there patients may have dermatitis, mouth sores and anemic conditions (Burns 13).

Prevalence

Epidemiologic studies of the celiac disease are few where its occurrence is common but ignored in many parts of the world. This may be as a result of its confusion with other diseases and misdiagnoses. Celiac disease is notable in all individuals worldwide irrespective of age of their social status. All the same, Celiac disease is prevalent in Caucasians and European countries especially Ireland, Austria, Sweden, as well as Ireland where women are greatly affected as compared to men. For instance, in Northern Ireland, in every three hundred people, one patient is diagnosed with celiac disease. In Finland, one in every hundred people has it. In comparison, in North America one in every three thousands people has the disease. However, these figures underestimate its prevalence since the studies do not consider individuals who fail to manifest any symptoms until a later age. Therefore, the prevalence in the United States could closely resemble that of Europe.  Over two million individuals in the US have celiac disease. (MedicineNet pr. 2).

According to medical study conducted by the University of Maryland, one in every 133 individuals has the disease in a general population which interprets to 2.2 million Americans. The study pointed out that “at risk groups… was one in 22 people in first degree relatives, one in 39 people in second degree relatives, and one in 56 people who had gastrointestinal symptoms or a disorder associated with celiac disease” (Tessmer 17) .Celiac disease is frequent in individuals with gastrointestinal signs including 1st & 2nd degree relatives who exhibit the signs. Family history therefore becomes a risk factor of celiac disease. From the study, it is notable that there is “ a high prevalence of celiac disease in people who had related health issues, such as Type 1 diabetes, anemia, arthritis, osteoporosis, infertility, and Down’s syndrome, even if these people did not show gastrointestinal symptoms” (Tessmer 17)

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