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Celiac Disease: What? Who? How?

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Celiac Disease: What? Who? How?

Celiac Disease: What? Who? How?

Life changing, life long, no cure! This paper is to give knowledge and inform readers on what Celiac Disease is, who it effects, what it affects, and try to explain how it can interrupt a normal, life style to where most of us take for granted. Have you ever wondered what life would be like if you found out you could not eat normal everyday foods that most of us take for granted? What if one day you woke up and found out you could not eat something as simple and as popular as pizza? That you could not eat bread, cake, cookies, lasagna, spaghetti, or even drink beer? That every time you did, you would get sick. Well, for a growing percentage of Americans, that is what is becoming a reality. What is it? How do you get it? What does it do to you? Who can get it? These are just some of the questions I will be answering in this paper.
What is Celiac Disease? Well that’s a very good question. Celiac Disease or Gluten-Sensitive Enteropathy is a disease of the intestinal tract. It is a chronic tropical disease of intestinal malabsorption or in simple terms, an allergy to wheat products such as wheat, rye, barley, and oats (Reilly 116). Celiac Disease is a lifelong disease that can only be controlled by understanding CD and following a lifelong diet which excludes wheat, barley, and rye. Celiac Disease is a multisystem disorder that causes the body’s immune system to respond to proteins in certain grains which damage the small intestine. The wheat-type grain that has the protein gliadin (gives elastic properties to flour) is harmful to those who have CD. Barley-type grains have hordein (is a glycoprotein) and rye has secalin (a protein in rye). The chemical make-up of these three causes the body to have an immune reaction. Unfortunately, scientists and doctors do not understand why these grains do this. For informational purpose for readers who may be wondering what grains and grain derived products have harmful forms of gluten, here is a list. Barley, couscous, kamut, malt, matzo, rye, semolina, soy sauce, spelt, sprouted barley, teriyaki sauce (unless wheat free), triticale, udon, and wheat (Bower 2). The list also needs to include: all regular baking flour, breads, pasta, pastries and desserts made with any of the above. Even vitamin pills, candies, and some medicines may contain gluten. Most of the products listed above I have never heard of and are probably unknown to the average person. However, it is good to have knowledge in all of them, especially when one is out shopping for food.
Who does it affect? Well, it varies across racial groups, but most common in Caucasians. The highest reports of CD are in Ireland and England. Also it has been reported that CD has not been found in Japanese or Chinese groups, and it is very rare in African groups. One in 300 Caucasians are affected, but this number changes from year to year as more and more humans are diagnosed with the disease (Reilly 117). According to the article in “Is It In Your Genes?” by Philip R. Reilly, GSE (Gluten-Sensitive Enteropathy) is a familial disease and in the 1970’s research into GSE showed that GSE occurred in about 14% of siblings, 8% of parents, and 15% of the children of affected persons. The haplotype (combination of genes) known as DR3-DQ2 has the highest risk. But in addition to that, a person must not have DR4-DQ, another type of haplotype; otherwise, you may be at risk. The risk of the disease depends on what HLA (Human Leukocyte Antigen) pattern they inherit (Reilly 118).
GSE is a common disorder that is overlooked and is usually misdiagnosed. Most of the time physicians wait for specific signs and symptoms before they react. The good thing is that they have highly accurate diagnostic tests and a clear type of therapy which is best treated by a rigorous attention to diet in which one should avoid everything that has gluten in it. Over time however, ones that do not follow the specific dietary guidelines are at a higher risk to certain cancers such as non-Hodgkins lymphoma, esophageal cancer (malignancy of the esophagus) and adenocarcinoma of the small intestine.
What are the symptoms? Symptoms include: abdominal pain, cramping, bloating, constipation, diarrhea, chronic fatigue, gas, and fatty stools. Now after reading those symptoms, the average person would most likely go buy Pepto-Bismol, an anti-gas pill, or other form of diarrhea and bloating medicines. As you may be able to see just from reading the above, CD could easily be mistaken and misdiagnosed. Therefore, the next question is who should be tested? The answer is those with classic symptoms of chronic diarrhea, malabsorption, weight loss, and abdominal distention. You may also have iron deficiency anemia, recurrent fetal loss, infertility, those with IBS or irritable bowel syndrome, auto immune diseases, peripheral neuropathy, cerebelar ataxia, and dental enamel hypoplasia (Bower 7).
What is the first step to take? Well, the first step is to get a diagnosis. Before you go and get tested, make sure you continue to eat the same as you always have. If you change your eating habits before getting tested, it will affect the accuracy of the test. If and when a person goes, blood is taken and tested for the presence of IgA tissue transglutaminase (tTG) and immunoglobulin A antiendomysium (AEA) antibodies. These tests are 98% accurate for verifying if one has CD (Bower 9-10). Once a positive test has been occurred, an endoscopy can be ordered by the doctor where a biopsy is done. Basically a small flexible tube is put down your throat, then through the stomach, and into the small intestine so the doctor can take a scraping of the small intestine. In some very serious cases, they can go through the rectum to retrieve the scrapings. There is a newer type of technology called the wireless capsule endoscopy (Bower 10). This is where a miniaturized camera is swallowed and the remote camera visualizes and records its travel through the body. The drawback to that is with this procedure, if the villas (hair like follicles on the small intestine) are flat, then a regular endoscopy must still be done for the biopsy (Anatomy and Physiology 7th edition).
So how does gluten product cause these problems and why do the doctors have to get samples of the small intestine? Well, when chewing food, saliva mixes with the food, travels into the esophagus, then into the stomach where gastric juices mix with the food. As the food travels into the small intestine, nutrition from the food get absorbed through small projections called villi onto the surface of the small intestine. The villi absorb the nutrition. However, the gluten in certain grains cause the body to produce endomysial antibodies which cause an inflammatory process that destroys the villi. Villi and Microvilli are tiny projections that layer the small intestine. They are intestinal digestive enzymes, making the small intestine the main organ of digestion and absorption. So, if the villi become damaged, digestion of food becomes a major problem and will cause some of or all of the symptoms mentioned in the previous paragraphs (Anatomy and Physiology 7th edition).
The nice thing is that many grocery stores offer gluten-free foods, but they are more expensive then gluten foods. So one of the key things to do is work with your doctor and a nutritionist to set up a safe and healthy gluten-free diet. Then before you go out shopping sit down and make a list of the ingredients that you can and can’t use or eat. Then take that list with you when you go shopping. Pick a shopping venue that you are familiar with and comfortable with. Take a tour of the grocery store and find out where they keep their gluten-free products. Look for special gluten-free or natural food sections in your grocery store for foods and ingredients that the stores may not have in their regular food aisles. Also look for the federal food labels now being placed on all food products that are gluten-free. Read the labels very carefully making sure that the product does not contain anything that you can’t have. But, again be prepared to spend money. Gluten-free specialty foods cost a pretty penny so be smart about your purchases and you will have a happier tummy and wallet.
Is there a cure for Celiac Disease? No, there is not. There are no pills, lotions, injections, herbs, blood transfusions or anything else that can cure it. CD is a lifelong disease with no cure and can only be controlled by maintaining a Gluten-Free Life Style. To obtain a gluten-free lifestyle, a person must study and learn all there is to know about CD. There are many resources out there; CD is becoming more known and wide spread.

References
Reilly, R. P., (2004). Is it in your genes? Celiac Disease (Gluten-sensitive Enteropathy) (p. 116-118) New York: Cold Spring Harbor Laboratory Press

Bower, S. L., Sharrett, M. K., Plogsted, S. (2007). Celiac disease: A guide to living with gluten intolerance. New York: Demos Medical Publishing, L.L.C.

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