Celiac Disease Flashcards
What is Celiac Disease?
- 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.
does celiac disease cause damage to the small intestine?
yes, it results in malabsorption
How is CD diagnosed? How long does it take?
Diagnosis in 3 steps
- PE including blood tests for gluten antibodies (IgA based tests)
- EMA
- TTG
- DGP - small bowel biopsy
- implement the gluten free diet and symptoms subside.
What are the three gluten antibodies we look for on blood tests
EMA, TTG, DGP
What is non-celiac gluten sensitivity?
-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
with NCGS, individuals test negative for what, but still have _____
negative for celiac disease and wheat allergy
still have : gluten sensitivity
What are the main symptoms associated with celiac disease?
THERE ARE OVER 200!!!!
Main:
diarrhea, steatorheea, weight loss, abdominal distention, weakness, muscle wasting, growth retardation, fat us, constipation (mainly seen in infants)
What are the emotional symptoms related to celiac disease?
depression, irritability, mood changes, inability to concentrate
What may be OTHER presenting symptoms of celiac disease?
anemia appetite change decreased clotting dehyrdation delayed puberty infertility/amenorrhea edema electrolyte imablance osteoporisis GLUTEN ATAXIA signs of nutrient deficiency dermatitis herpetiformis
What is dermatitis hermetiformis?
It is the “celiac disease of the skin”.
-prurity papulovesicles on extensor surfaces, trunk, scalp, and neck.
What neurological condition can manifest as a result of malabsorption in CD?
GLUTEN ATAXIA!!
failure of muscle coordination because there is not proper absorption of nutrients.
CD is an autoimmune disease which has other associated autoimmune disease such as…
Type 1 Diabetes Thyroid Disease Addisions Sjogrens RA Vitiligo Raynuads
CD is associated with several cancers, such as:
Enteropathic-associated T-cell lymphoma
Small bowel adenocarcinoma
Esophageal squamous carcinoma
Oropharyngeal squamous carcinoma
both CD and NCGS respond to…
a gluten free diet!!!
How are CD and NCGS related to complications?
CD= known complications NCGS = unknown complications
In older children, signs of CD tend to be more (physical/emotional)?
emotitional
Children under three tend to have more physical/emotional symptoms?
physical–the signs of malabsorption
What are the most common nutrient deficiencies?
Iron B-12 Folic Acid Calcium Vitamin D Fiber
After 3-12 months of gluten free diet, what biomes undetected in the blood?
the IgA antibodies
After 3-24 months of a gluten free diet, what becomes normal?
mucosal biopsy
What does a mucosal biopsy show if someone has CD?
shows loss of intestinal villi
What are 3 good supplements to give someone with CD?
- multivitamin
- vit D
- calcium
Is there any medical drug treatment for CD?
no, diet is the treatment
What are the three steps to self-management?
- foundation–> switch to gluten free
- expansion–> see what foods can be tolerated
- maintenince–> planning meals ahead and updating plan as needed
Where can gluten be found?
wheat
barley
rye
oats (unless gf)
What are the current recommendations for someone with CD on how many oats they should consume?
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
What are the FDAs regulation for gluten free?
-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
What group has a requirement of <5 ppm?
CSA
What groups have a requirement of <10 ppm?
GIG, NFCA
