Celiac disease


Celiac disease

Description of celiac disease

Celiac disease is a chronic autoimmune disease of the small intestine, which is sensitive to the mixture of proteins calledgluten or gluten (hence one of the names of the disease – gluten-sensitive enteropathy). Gluten is primarily contained in wheat flour, but also in barley and rye.

This disease ill only predisposed individuals who develop exaggerated antibodies against certain enzymes and proteins that are part of the gluten (the gliadin part), and these antibodies then these like allergens (more correctly speaking antigens) coalescing to give complexes damaging subsequently intestinal mucosa that there cause inflammation which, when prolonged course of gradually changing its appearance and function.

Initially assumed that these diseases are fairly rare, by contrast, shows that it is a relatively frequent illness if ingested sensitive diagnostic methods (especially blood samples for antibodies) and score also incomplete and atypical forms of the disease.

In the Czech Republic classified according to estimates found 50,000 cases, ie. It’s sick about one person out of two hundred.The idea that it is a disease of childhood is wrong.

Celiac sprue can occur at any age. In adulthood so often happens after physical or psychological stress of various types (for example, women’s birth can be, for both sexes without an operation), mostly between 30th-40th year. Until then, may have individual unexplained anemia (anemia), which is caused by impaired absorption of important vitamins from the intestine to the bone marrow.

Celiac disease is also sometimes occurs with other diseases that it may precede or follow her vice versa. These so-called. Comorbid conditions are sometimes also important in diagnosis, when through them comes to celiac disease, or vice versa physicians always searching for these diseases, when a patient diagnosed celiac disease.

They are: diabetes (diabetes mellitus type 1, or the one that arises in youth is associated with obesity and patients must inject insulin from the start, compared to type 2 diabetes is far less common), IgA deficiency (IgA missing that are important in mucosal immunity), thyroid disease,infertility and skin disease called dermatitis herpetiformis During. This is manifested rash like herpes (herpes virus causes cold sores) on the elbows, knees, buttocks and face. When properly gluten-free diet, disappears along with intestinal symptoms and rashes.

 

Risk factors for celiac disease

Celiac disease is not caused primarily by genetic engineering. Higher incidence observed in relatives of the first degree, ie. at my parents. Inheritance can not pinpoint as some other diseases where we can easily calculate how many children will be ill parents of sick and healthy much. It is assumed the influence of the external environment.

Physical and mental burden that I mentioned at the beginning, it’s just a triggering factor, not the cause of the disease.

 

Progress and symptoms of celiac disease

There are five forms of celiac sprue. The most classic is that which manifests malabsorption syndrome, which is a set of symptoms that result from malabsorption of nutrients in the small intestine.

Patients tend to be particularly weak, considerably slimmer and have diarrhea (from the water absorption disorders) characterized by yellow, because the fats are not absorbed. Weakness is conditional addition to inadequate nutrition associated with energy deficiency anemia as well (anemia). With that is also associated with pale skin and breathlessness – patients are harder to breathe.

Like vitamin B12 is not absorbed important in hematopoiesis, not absorbed nor vitamin K to the liver ensures the production of proteins required for blood clotting (ie. The coagulation factors).Patients may therefore have bleeding problems – bruising, excessive bleeding from an open wound, or even hidden (internal) bleeding into joints, muscles and soft tissues.

Furthermore, it is difficult to absorb vitamin D, one of the control factors of calcium metabolism.When lack of vitamin D, calcium is lacking from the ingested food through the intestinal wall into the blood and the blood calcium level drops. Organism compensates degradation of calcium from the bone, creating a so-called. Metabolic osteopathy either as osteoporosis or osteomalacia. Both diseases may present with bone pain and twitching and cramps.

The principle of these expressions is that the vitamins are absorbed by means of fats and when absorbed fats do not go with them from the intestine or vitamins. Suffers from lack of vitamins our skin and thus gives rise to various skin problems – eg. “Corners” of the lips, skin abscesses, fraying nails, hair loss.

Patients may also have swollen, distended abdomen, which contrasts with the otherwise emaciated body. They may feel bloated.

Sometimes the disease is manifested by neurological symptoms, for which it is responsible again lacking vitamins. It is usually a tingling missing limbs, others perception of pain, touch and pressure, or tingling. But it may also apply motility disorders or inadequate reflexes.

From the above symptoms is by far not appear all at once, or may not appear at all. It is then theasymptomatic form when patients does no symptoms. Intestine but despite being injured. This form of ill nearly a fifth of people, so the disease often comes too late. A good guide can be celiac disease in the family or any of the associated diseases. Of mono form, are only one symptom or symptoms that concern only one area – for example, neurological signs or symptoms related to anemia).

The course of the disease depends on the adherence to the dietary regimen. The patient’s condition improved significantly after deployment gluten-free diet and vice versa significantly worsen after ingestion of food containing gluten. Even a small number of drugs are able to reactivate disease.This may occur even after stress such as childbirth, trauma or any infection.

The illness may complicate causes the cancer – lymphoma or cancer of the digestive tract. After ten years of the disease leads to formation of such cancer in 15% of cases. The problem could become even feeding nutrients that initially parenteral – into a vein. When the disease is stabilized, the patient receives dietary food normally intestine. If not treated, or about his illness he did not know the intestine mucosa due to constant exposure to gluten as if to die (atrophy) and nutrient uptake is then dependent on life parenteral route of administration.

 

examination of celiac disease

For diagnosis is crucial positive serological tests (a simple blood sampling), which follow different antibodies by the immune system produces against components of its own tissues and gliadin. They can also serve to monitor the treatment, the patient is adhering properly diet.

The second examination is introduced via endoscopy tube into the small intestine. The doctor removes you also removes a small sample of mucous membrane and sends him on histological examination.

When you deploy unclear findings gluten-free diet to be tried whether her illness will improve – the symptoms disappear or somehow change the appearance of the mucosa observed by the physician endoscopy.

 

treatment of celiac Disease

The treatment is gluten-free diet. It is necessary to eliminate flour, wheat, rye, barley, including foods that contain these ingredients in small amounts – sauces, preserves, sausages and beer. The suitability of oat products is not quite definite opinion. It is recommended that initially is also omitted later try to consume, but limited.

Holidays soy and rice flour, rice, potatoes, corn, potato starch and corn. Of the alcohol is permitted wine and spirits, all in moderation of course. The diet should be followed for life.

When signs of lactose intolerance current limiting consumption of dairy products.

When failure of treatment with a doctor first must make sure that you did not follow the diet mistake somewhere, then you will deploy corticosteroid, which suppresses the inflammatory response and in addition accelerate the maturation of new lining of the intestinal mucosa.

An integral part is the replacement of all components of the nutrients that a patient missing, including fat-soluble vitamins and some minerals (such as calcium, magnesium).

Other names: celiac sprue, gluten enteropathy, endemic sprue, primary malabsorption syndrome, Gee-Herterova disease

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