1. JESSIE BUTTS AMANDA SCHUESSLER Celiac Disease

2. What is Celiac Disease? Genetically based autoimmune disease  Of all 8 0, only one with a known trigger Autoimmune disease: antibodies attack against its own tissues Attacks and damages small intestine and villi 2 million Americans have Celiac Disease Affects 1% of the population  North America, South America, Europe, North Africa, India

3. What is Gluten? Wheat protein Substance that makes wheat elastic Contains Gliadians (part of gluten protein)  Triggers Celiac and wheat allergy  Provide marker for assessing gluten contents in food  Induces mucosal flattening

4. Video http://www.youtube.com/watch?v=CfaiALf_014

5. How is it Treated? Removing gluten turns off autoimmune process Only cure is gluten free diet  Wheat, spelt, kamut, rye, barley, triticale, oats Complete remission with lifetime gluten free diet  Intestinal damage and symptoms can be reversed

6. Gastro-intestinal Symptoms Discomfort and bloating Diarrhea, constipation Nausea and vomiting Flatulence Reflux Secondary lactose intolerance Damage to intestinal mucosa Weight gain, then weight loss

7. Non-Gastrointestinal Symptoms Most common symptoms are non-gastrointestinal Iron and folate deficiencies Osteoporosis Chronic fatigue General weakness Muscle or joint pain Recurrent canker sores Dermatits Herpetiforimis Liver abnormalities Reproductive system disorders and infertility Depression Associated autoimmune disease

8. What Happens? Jejunal villi increase surface area to digest and absorb food Antibodies decrease size of villi until flat  Malabsorption, decrease surface area Individuals with Celiac have lowered immune system functioning  Not enough nutrients absorbed

9. How Has it Come About? Gluten based diets have only existed for the last 1% of evolutionary history Humans have not fully adapted  Not in our genes to be able to process it Identified in 1888 Link to gluten not understood until 1950’s Removal of gluten in rations from war  When rations returned, symptoms returned

10. IgA Wheat Allergy Faster onset of symptoms True allergy, usually in consumption 2 in 1000 Typically see an allergist Symptoms include:  Tissue swelling  Facial swelling/hives  Nausea/vomiting

11. Testing Often confused with IBS and hypothyroidism Blood tests  90% accurate  Antibodies are very sensitive Small intestine biopsy  Most accurate way of testing

12. Genetic Disorders IgA deficiency Down syndrome, Turner’s Syndrome, William’s Syndrome Cancer  T-Cell Lymphoma, Small intestine adenocarcinoma, digestive tract cancer

13. What Can They Eat? Tapioca Corn Potatoes Rice  White and brown Millet Quinoa Sorghum Buckwheat Chia seeds 10-100mg of gluten is still considered “harmless” Many gluten free foods are processed  Contain very little fiber, B Vitamins, and Magnesium

14. Sources Hischenhuber, C., Crevel, R., Jarry, B., MÄki, M., Moneret- Vautrin, D. A., Romano, A., &... Ward, R. (2006). Review article: safe amounts of gluten for patients with wheat allergy or coeliac disease. Alimentary Pharmacology & Therapeutics, 23(5), 559-575. doi:10.1111/j.1365- 2036.2006.02768.x I can't eat that!. (2012). Harvard Women's Health Watch, 19(11), 4-5. Lowth, M. (2014). Coeliac disease: clinical features, diagnosis and management. Practice Nurse, 44(8), 36-40. Lugg, J. (2010). Celiac Disease, Gluten Sensitivity, and the Gluten-Free Diet. Macrobiotics Today, 50(3), 22-28.