CELIAC DISEASE BY EMER BYRNE

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Presentation transcript:

CELIAC DISEASE BY EMER BYRNE Koiliakos (greek) = abdominal Endemic Spure (chronic form of mal-absorption syndrome) Gluten Enteropathy Non-tropical Spure

CHARACTERISTICS Autoimmune Disease (delayed allergy) (Triggered; surgery, pregnancy, viral infection) Small Bowl Reaction to Gliadin [gly-eh-din] (Gluten protein found in Wheat) Children (9-24mts) – Bowl symptoms Adults – Malabsorption related problems

PATHOLOGY Exposure to Gliadin Enzyme Tissue Transglutaminase modifies Cross-reaction with bowl tissue Inflammatory reaction Flattening in villi Interfering in absorption of nutrients

SYMPTOMS Fatigue Chronic Diarrhea Failure to thrive (children) Weight loss (adults) Malabsorption related symptoms - Anemia (fe def, and megaloblastic) - Vit. K def - Osteopenia (Ca and Vit D def)

COMPLICATIONS Lymphoma Adenocarcinoma Osteoporosis Ulcerative jejunitis and stricturing (ulcers and narrowing)

FOODS TO AVOID All foods containing wheat, barely, rye and oats - bread, pasta, cereals and beer Artificial flavourings and colourings Crisps and sweets Vitamins, Medicines Specific spirits Stamp and Envelope adhesives

DIAGNOSIS Blood tests - IgA - Anti EMA ( Endomysium) - Anti TTg ( Tissue Transglutaminase) Endoscopy ( Gold standard)

ENDOSCOPY Upper GI Endoscopy - EGD ( esophagogastroduodenoscopy ) Visual examination of upper GI Lighted, flexible fibro-optic or video scope 15-30 mins Outpatient procedure No pain

Pathologic Duodenum Normal Duodenum

TREATMENT Lifelong gluten-free diet - Potato - Rice - Unprocessed; meat, fish, fruit and vegetables - Wine - Rum and Tequila

GLUTEN-FREE FOODS Most foods are now available in gluten-free

PROGNOSIS Intestinal damage begins to heal within weeks

WHY NOW?? Glutens; very cheap and tasty - used more and more in unprocessed foods - larger profits for food manufactories Water soluble gliadin = Problem - fine grinding, baking, fermenting, chemical treatment and synthesis

EPIDEMIOLOGY 1% of Indo-Europeans; - Celtics - Balts - Germanic Peoples - Latins - Slavs Prevalence - 1/300 Ireland - 1/133 America (3 million)

THANK YOU FOR YOUR ATTENTION

REFERENCES http://www.celiac.org/ http://www.celiac.nih.gov/ http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/ http://www.csaceliacs.org/ http://www.glutenfreeoats.com/