Celiac Disease By Fatima Amanullah

Pathology Celiac Disease is also known as gluten-sensitive enteropathy. It occurs when gluten is consumed and acts as a toxin resulting in damage of the lining of the small intestine. The damage from the gluten makes it hard for the small intestine to absorb vital nutrients such as carbohydrates, proteins, fats, vitamins and minerals. Celiac disease is a digestive disorder as well as an autoimmune disorder.

Signs and Symptoms The biggest symptom of Celiac Disease is digestive problems. This includes abdominal bloating, pain and gas, headaches, fatigue, joint paint, muscle cramps, seizures, acid reflux, tingling sensations in the legs and loss of bone density. Loss of bone density can lead to osteoporosis. Tingling sensations in the legs is due to nerve damage and lack of calcium. Signs of Celiac Disease include chronic diarrhea, pale stools, missed menstrual periods and weight loss. A skin rash called dermatitis herpetiformis appears on the individual. They can also be diagnosed with iron deficiency anemia.

Medical Treatments Celiac Disease has no medical treatment. However, the symptoms can be treated and controlled. An individual that is diagnosed with Celiac Disease cannot eat any food that contains gluten. Wheat, barley, rye and oats all have to be prevented. This is usually done through a gluten-free diet. If affected individual eats gluten, the symptoms explained previously will worsen. Patients who are on gluten-free diets have to stay on the diet for the rest of their life in order to prevent further complications If the small intestine is severely damaged, the patient can be prescribed with steroids to ease the symptoms. In some cases, however, the small intestine is too damaged for the steroids to have an effect. The patient would have to avoid gluten as much as possible.

Etiology Celiac Disease is caused when the body’s immune system overreacts to gluten in food. The immune system of the body is supposed to protect against foreign invaders. However, an abnormal immune reaction causes the body to develop antibodies against gluten. The immune reaction damages the villi that line the intestines. Once the villi are damaged, the nutrients in the food cannot be absorbed. The actual cause behind the immune reactions are unknown. Celiac Disease is more likely to develop if an individual has certain gene mutations. One must remember that having the gene mutation does not mean the individual will have Celiac Disease – only their risks will be increased. This is an example of what normal and damaged villi look like

Prognosis Patients who have Celiac Disease normally start gluten-free diets. The recovery of the small intestine will begin immediately. Complete recovery ranges for each patient. The recovery period can take anywhere from a few months to several years. If a patient is diagnosed early and starts a strict, gluten-free diet right away, they have a high chance of being able to live a healthy and active life. Patients with the disorder have to be very careful when buying foods with gluten especially since it is crucial for recovery. If affected individuals continue consuming gluten, many complications can occur including malnutrition, loss of calcium and bone density, miscarriage, lactose intolerance and in some cases, cancer. Mortality rate for patients following the gluten-free diet is very close to the mortality rate of the general population.

Impacts On Other Body Systems Celiac Disease is a reaction to the body’s immune system not functioning properly. The immune system affects the digestive system this way. This creates a chain reaction where other body systems are also affected. The Circulatory System – Anemia is a symptom of Celiac disease. When the villi in the intestines are damaged, they cannot absorb vital nutrients (iron included). This results in a lack of hemoglobin. The name of this condition is iron-deficiency anemia. The Skeletal System – Once again, due to a disruption in the absorption of nutrients, bones do not get the required amount calcium. This can lead to osteoporosis. Problems with the skeletal system occur mainly in children who still have developing bones.

Interesting Facts A 100% gluten-free diet is the only treatment for Celiac disease. Almost 90% of affected patients are undiagnosed or misdiagnosed with Celiac disease. September 13 is Celiac Awareness Day. Celiac Disease can increase your risk of developing lymphoma. Celiac Disease can be mistaken for problems such as food intolerance or irritable bowel syndrome. Celiac disease is not like an allergy and cannot be “outgrown” Celiac Disease is an inherited condition and may appear at any age.

Impacts on the Individual For most of the time, affected individuals would not have problems interacting with people in their environment. If the individual stayed on a gluten-free diet, their symptoms would decrease therefore they would be able to live a healthy lifestyle. Since Celiac disease affects the intestines, the individual should not feel worried about any visible symptoms or their appearance. However, the individual may feel left out due to their inability to participate in activities which requires them to eat gluten. Such examples are going to the theatre, eating at a restaurant or even attending parties. The risk of cross-contamination is high and even the slightest bit of gluten can severely damage the small intestine. If I had this disorder, I would feel upset (who wouldn’t be?). I think that overtime, I would be able to adjust to the gluten-free diet because I am a flexible person. However, it would take me a while to adjust. This is because people on gluten-free diets must keep a 100% positive attitude. I am certain that I would have great difficulty keeping a positive attitude for the rest of my life.

Impacts on the Individual Since there is no treatment for Celiac disease, the individual would not have to worry about payment for medications. However, they would have to put money towards buying gluten-free foods and tons of recipe books for gluten-free diets. They would also have to put time and energy into checking every food they buy for gluten. The individual should be able to afford following the gluten-free diet. However, it might cost a lot of money to buy organic fruits and vegetables opposed to bread and junk- food. The individual would certainly be able to go to school/work. As long as they stay on their gluten-free diet, these individuals can go anywhere. Also, additional support form family and friends can help the individual feel more confident in public.

Impacts on the Family The family themselves would have no problem interacting with the public. Celiac disease is not something to be ashamed of. The family could easily interact with friends and coworkers. For the majority of the time, the families would not feel embarrassed, angry or upset. However, it is possible that one or more family members are also diagnosed with the condition. This may lead to frustration, especially since a portion of the family cannot consume gluten. The family would feel mostly sympathetic towards the individual. They would support them in every way possible. However, there is a chance that the family becomes a little bit irritable. This would only be due to the fact that it takes a lot of work and energy to find gluten-free foods.

Impacts on the Family There is no medical treatment for Celiac disease. The family would not have to to worry about paying for medication. They would, however, have to pay for gluten-free foods and stay away from common household staples such as bread and pasta. The family would definitely be able to afford following the gluten-free diet. The family can help the individual go to school/work by giving support. One of the biggest components of being able to follow the gluten-free diet is having a good attitude. The family of the individual must show constant love and support in order for the individual to live a healthy life. The family can do lots for the individual including things like explaining the child’s condition to the teachers or principal.

Impacts on the Community If friends and peers of the individual knew more about the condition, they would have sympathy towards the individual. The public would treat them the same way they treat everyone else. Problems could arise from public places like restaurants. Waiters and chefs may not understand what Celiac disease and is and end up showing signs of disbelief or anger. This could become very embarrassing, especially if the affected individual had to argue with a waiter in public. The community can help affected individuals by increasing awareness of Celiac disease. At schools, adaptations include separate gluten-free foods available for those who need it. Also, teachers can inform classmates of the individual about Celiac disease. This would minimize bullying at school. In the community, certain supermarkets can have separate aisle and sections with gluten-free food. This would make it easier for people with Celiac Disease to feel comfortable in their environment.

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