Celiac Disease

Question 1

What is Celiac Disease?

Answer 1

• Celiac disease (CD) is a AUTOIMMUNE genetically linked disease with an environmental trigger (genes DQ2 and DQ8).
• Eating certain types of protein fractions, commonly called gluten, sets off an autoimmune response that causes damage to the small intestine.

Question 2

does celiac disease cause damage to the small intestine?

Answer 2

yes, it results in malabsorption

Question 3

How is CD diagnosed? How long does it take?

Answer 3

Diagnosis in 3 steps

1. PE including blood tests for gluten antibodies (IgA based tests)
   - EMA
   - TTG
   - DGP
2. small bowel biopsy
3. implement the gluten free diet and symptoms subside.

Question 4

What are the three gluten antibodies we look for on blood tests

Answer 4

EMA, TTG, DGP

Question 5

What is non-celiac gluten sensitivity?

Answer 5

-Nonallergic
-Innate immune response to gluten
-Is thought not to cause damage to the small
intestine
-Individual tests negative for celiac disease
and wheat allergy but has adverse
response to gluten
-Diagnosis remains one of exclusion

Question 6

with NCGS, individuals test negative for what, but still have _____

Answer 6

negative for celiac disease and wheat allergy

still have : gluten sensitivity

Question 7

What are the main symptoms associated with celiac disease?

Answer 7

THERE ARE OVER 200!!!!
Main:
diarrhea, steatorheea, weight loss, abdominal distention, weakness, muscle wasting, growth retardation, fat us, constipation (mainly seen in infants)

Question 8

What are the emotional symptoms related to celiac disease?

Answer 8

depression, irritability, mood changes, inability to concentrate

Question 9

What may be OTHER presenting symptoms of celiac disease?

Answer 9

anemia
appetite change
decreased clotting 
dehyrdation
delayed puberty
infertility/amenorrhea
edema
electrolyte imablance
osteoporisis
GLUTEN ATAXIA
signs of nutrient deficiency 
dermatitis herpetiformis

Question 10

What is dermatitis hermetiformis?

Answer 10

It is the “celiac disease of the skin”.

-prurity papulovesicles on extensor surfaces, trunk, scalp, and neck.

Question 11

What neurological condition can manifest as a result of malabsorption in CD?

Answer 11

GLUTEN ATAXIA!!

failure of muscle coordination because there is not proper absorption of nutrients.

Question 12

CD is an autoimmune disease which has other associated autoimmune disease such as…

Answer 12

Type 1 Diabetes
Thyroid Disease
Addisions
Sjogrens
RA
Vitiligo
Raynuads

Question 13

CD is associated with several cancers, such as:

Answer 13

Enteropathic-associated T-cell lymphoma
Small bowel adenocarcinoma
Esophageal squamous carcinoma
Oropharyngeal squamous carcinoma

Question 14

both CD and NCGS respond to…

Answer 14

a gluten free diet!!!

Question 15

How are CD and NCGS related to complications?

Answer 15

CD= known complications
NCGS = unknown complications

Question 16

In older children, signs of CD tend to be more (physical/emotional)?

Answer 16

emotitional

Question 17

Children under three tend to have more physical/emotional symptoms?

Answer 17

physical–the signs of malabsorption

Question 18

What are the most common nutrient deficiencies?

Answer 18

Iron
B-12
Folic Acid
Calcium
Vitamin D
Fiber

Question 19

After 3-12 months of gluten free diet, what biomes undetected in the blood?

Answer 19

the IgA antibodies

Question 20

After 3-24 months of a gluten free diet, what becomes normal?

Answer 20

mucosal biopsy

Question 21

What does a mucosal biopsy show if someone has CD?

Answer 21

shows loss of intestinal villi

Question 22

What are 3 good supplements to give someone with CD?

Answer 22

1. multivitamin
2. vit D
3. calcium

Question 23

Is there any medical drug treatment for CD?

Answer 23

no, diet is the treatment

Question 24

What are the three steps to self-management?

Answer 24

1. foundation–> switch to gluten free
2. expansion–> see what foods can be tolerated
3. maintenince–> planning meals ahead and updating plan as needed

Question 25

Where can gluten be found?

Answer 25

wheat
barley
rye
oats (unless gf)

Question 26

What are the current recommendations for someone with CD on how many oats they should consume?

Answer 26

50 grams per day (50/g day is equivalent to about 1/2c dry oats) for adults
25 grams per day (25g/day is equivalent to about 1/4 cup dry oats) for children

Question 27

What are the FDAs regulation for gluten free?

Answer 27

-Cannot contain wheat, barley, rye (W, B, R)or a crossbred hybrid of these grains
-Cannot contain ingredient derived from W, B, R that has not been processed to remove gluten
-Can contain an ingredient derived from W, B, R that has been processed to remove gluten but with final product containing
< 20 ppm gluten
-Must contain <20 ppm or less gluten, whether gluten comes from an ingredient or is in the food unintentionally due to cross contact

Question 28

What group has a requirement of <5 ppm?

Answer 28

CSA

Question 29

What groups have a requirement of <10 ppm?

Answer 29

GIG, NFCA