Celiac disease is a genetic autoimmune disorder triggered by ingesting gluten that damages the small intestine. It affects approximately 1% of the global population. The only treatment is a lifelong gluten-free diet, which resolves symptoms and intestinal damage within weeks to months. Left untreated, celiac disease can cause malnutrition, bone loss, infertility and cancer due to nutrient malabsorption.
Celiac disease is a genetic autoimmune disorder triggered by ingesting gluten that damages the small intestine. It affects approximately 1% of the global population. The only treatment is a lifelong gluten-free diet, which resolves symptoms and intestinal damage within weeks to months. Left untreated, celiac disease can cause malnutrition, bone loss, infertility and cancer due to nutrient malabsorption.
Celiac disease is a genetic autoimmune disorder triggered by ingesting gluten that damages the small intestine. It affects approximately 1% of the global population. The only treatment is a lifelong gluten-free diet, which resolves symptoms and intestinal damage within weeks to months. Left untreated, celiac disease can cause malnutrition, bone loss, infertility and cancer due to nutrient malabsorption.
Celiac disease is a genetic autoimmune disorder triggered by ingesting gluten that damages the small intestine. It affects approximately 1% of the global population. The only treatment is a lifelong gluten-free diet, which resolves symptoms and intestinal damage within weeks to months. Left untreated, celiac disease can cause malnutrition, bone loss, infertility and cancer due to nutrient malabsorption.
Celiac disease also known as gluten-sensitive enteropathy
Is a digestive and autoimmune disorder that results in damage to the lining of the small intestine when foods with gluten are eaten Is the most common genetically related food intolerance, worldwide. Is a multifactorial ,autoimmune disorder that occur in genetically susceptible individuals It is triggered by a well identified environmental factor. (GLUTEN AND RELATED PROLAMIN PRESENT IN WHEAT, RYE,AND BARLEY) EPIDEMIOLOGY Globally celiac diseases affects between 1 in 100 and 1in 170 people However vary between different regions of the world from as 1 in 300 to as many as 1 in 40 In the United States it is thought to affect between 1 in 1750 (defined as a clinical disease including dermatitis herpetiformis with limited digestive tract symptoms) to 1 in 105 ( defined by presence if IgA TG in blood donors) However, population studies from part of Europe, India, South America ,Australia, and USA (using serology and biopsy) indicate that the precentage of people with the diseasemay be between 0.3 and 1.06% in children (but 5.66% in one study of children of the predisposed Sahrawi people) and 0.18-1.2% in adults. Among those in primary care population who report gastrointestinal symptoms, the rate of celiac disease is about 3% MORTALITY AND MORBIDITY The morbidity rate of celiac disease can be high Its complication range from osteopenia, osteoporosis, or both to infetility in women, short stature, delayed puberty, anemia and even malignancies (mostly related to the GI tract). As a result the overall mortality in patients with untreated celiac disease is increased. Evidence also suggests that the risk of mortality is increased in proportion to the diagnostic delay and clearly depends on the diet Person who do not follow a gluten - free diet have an increased risk of mortality ,as high as 6 times that of the general population the increased death rates are most commonly due to intestinal malignancies that occur within 3years of diagnosis SEX AND AGE
Celiac disease can occur at any stage in life
A diagnosis is not unsual in people older than 60 years Classic GI pediatric cases usually appear in children aged 9-18 months. Celiac disease may also occur in adults and is usually precipitated by an infectious diarrheal episode or other intestinal disease PATHOPHYSIOLOGY CAUSES Normally, the body’s immune system is designed to protect it from foreign invaders Your genes combined with eating foods with gluten and other facotrs can contribute to celiac disease, but the precise cause isn’t known. Infant feeding practices, gastrointestinal infections and gut bacteria might contribute as well. Sometimes celiac disease becomes active after surgery, pregnancy, childbirth, viral infection or severe emotional stress. When the body’s immune system overreacts to gluten in food, the reaction damages the villi. RISK FACTORS Celiac disease tends to be more common in people who have: A family member with celiac disease or dermatitis herpetiformis Type 1 diabetes Down syndrome or Turner syndrome Autoimmune thyroid disease Microscopic colitis Addison’s Disease SIGNS AND SYMPTOMS The signs and symptoms of celiac disease can vary greatly and fiffer in children and adults. Digestive signs and symptoms for adults include: Diarrhea Fatigue Weight loss Bloating and gas Abdominal pain Nausea and Vomiting Constipation However, more than half the adults with celiac disease have signs and symptoms unrelated to the digestive system, including: Anemia, usually from iron deficiency Loss of bone density (osteoporosis) or softening of bone (osteomalacia) Itchy, blistery skin rash (dermatitis herpetiformis) Mouth ulcers Headaches and fatigue Nervous system injury, including numbness and tingling in the feet and hands, possible problems with balance, and cognitive impairment Joint pain Reduced functioning of the spleen (hyposplenism) Children with celiac disease are more likely than adults to have digestive problems, including: Nausea and vomiting Chronic diarrhea Swollen belly Constipation Gas Pale, foul-smelling stools coordination and seizures The inability to absorb nutrients might result in: Failure to thrive for infants Damage to tooth enamel Weight loss Anemia Irritability Short stature Delayed puberty Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), learning disabilities, headaches, lack of muscle coordination and seizures COMPLICATIONS MALNUTRITION,BONE WEAKENING,INFERTILITY AND MISCARRIAGE, LACTOSE INTOLERANCE, CANCER AND NERVOUS SYSTEM PROBLEMS NONRESPONSIVE CELIAC DISEASE Some people with celiac disease don’t respond to what they consider to e a gluten-free diet. Nonresponsive celiac diseae is often due to contamination of the diet with gluten. Bacteria in the small intestine (bacterial overgrowth) Microscopic colitis Poor pancreas function (pancreatic insufficiency) Irritable bowel syndrome Difficulty digesting sugar in dairy products( lactose) (sucrose), or type of sugar found in honey and fruits (fructose) Refractory celiac disease LABARATORY AND DIAGNOSIS SEROLOGY TESTING : looks for antiodies in your blood .Elevated levels of certain antibody proteins indicate an immune reaction to gluten GENETIC TESTING: for human leukocyte antigen (HLA-DQ2 and HLA-DQ8) can be used to rule out celiac disease ENDOSCOPY: this test uses a long tube with a tiny camera that’s put into your mouth and passed down your throat . The camera enables your doctor to view your small intestine and take a small tissue sample to analyze for damage to the villi CAPSULE ENDOSCOPY: this test uses a tiny wireless camera to take pictures of your entire small intestine, the camera sits inside a vitamin -sized capsule ,which you swallow .As the capsule travels through your digestive tract, the camera takes thousands of pictures that are transmitted to a recorder. If your doctor suspects you have dermatitis herpetiformis, he or she might take a small sample of skin tissue to examine under a microscope TREATMENT Medical care total lifelong avoidance of gluten ingestion is the cornerstone treatment for patients with celiac disease Wheat,rye and barley are the grains that contain toxic peptides. They should be eliminated as completely as possible, although daily intake doses larger than 10mg are likely needed to cause mucosal reaction. GI symptoms in patients with asymmomatic CD who adhere to a gluten- free diet typically resolve within a few weeks; these patients experience the normalization of nutritional measures, improved growth in height and weight and normalization of hematological and biochemical well being. Treatment with a gluten free diets reverses the decrease in bone mineralization and the risk for fractures. Lactose is often eliminated in the initial phases od dietary treatment as well.This is because lactase deficiency is thought to accompany the flat mucosa. MEDICATION
Glucocorticoids may be needed for
refractory disease Corticosteroids can rapidly control severe symptoms of celiac disease. They my also have a role in rare cases in which the patient has no response to diet;this condition is known as refractory celiac disease and occurs exclusively in adults For celiac disease in children ,steroids are almost never needed. DIET TAKING SUPPLEMENTS GLUTEN-FREE DIET Sometimes people with celiac disease can be deficient in You’ll need to avoid foods made with wheat and wheat flour. You also can’t eat foods that contain certain nutrients because their body doesn’t absorb them any of the following grains because they also properly. The most common include have gluten in them: Iron RYE Calcium BARLEY Fiber DURUM Zinc FARINA MALT Vitamin D SEMOLINA Niacin Magnesium Folate NURSING INTERVENTION Monitor dieatary intake, fluid intake and output, weight ,serum electrolytes and hydration status Make sure that the diet is free from causative agent, but inclusive of essential nutrients, such as protein, fats, vitamins and minerals Provide parental nutrition as prescribed Provide meticulous skin care after each loose stool and apply lubricant to prevent skin breakdown Enocurage small frequent meals, but do not force eating if the child has anorexia Use meticulous hand washing technique and other procedures to prevent transmission of infection Assess for fever cough, irritability or other signs of infection Teach parents to develop awareness of the childs condition and behavior recognize changes and care for child accordingly THANK YOU