CELIAC DISEASERACHEL KINZIE, DIETETIC INTERN 2011

Outline

What is it?

Symptoms

Who Does it Affect?

What is going on in the body?

What is it?

People with celiac disease cannot tolerate a protein called GLUTEN, found in wheat, rye, and barley

A digestive disease that interferes with absorption of nutrients from food.

Who Does it Affect?

It affects 1 in 133 people in the U.S. It is Genetic

Because of the genetic component, it is found in 5 to 15 % of siblings and offspring of celiacs.

It affects both children and adults

Who Does it Affect?

Sometimes it is triggered for the first time after surgery, pregnancy, child birth, or severe emotional stress.

Where Celiac Disease Targets

Symptoms

Flatulence Constipation Bloating Indigestion Steatorrhea Abdominal pain*note that many newly diagnosed persons

with celiac disease report no gastrointestinal symptom

How Do Symptoms Differ With Age?

In the past, celiac disease was considered to be a disease primarily of infants and children.

It is now clear that the initial signs and symptoms of celiac disease can occur in adults and even in the elderly.

How Do Symptoms Differ With Age?

Infants/Children Steatorrhea, abdominal cramps, abdominal

distension, short stature (children), failure to thrive (infants)

Adults May have classic symptoms, but many either

have no symptoms or vague abdominal discomfort

What is Celiac Disease is Not

It is NOT an allergy

Allergic Reaction

AA

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Allergen

• Histamines Released• Allergy Symptoms…

•Rash•Itchy/watery eyes•Difficulty breathing•Sometimes…

Abd. crampsVomitting Diarrhea

•Antihistamines can help with symptoms

What Causes Celiac Disease?

Intolerance to Glutenan autoimmune

disorder

Autoimmune Disorder (Celiac)

A A

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Gluten

•Body attacks itself

•Antihistamines will NOT help

The Small Intestine

What Does the Small Intestine Do?

Tiny fingerlike projections called “villi” allow nutrients from food to be absorbed into the bloodstream.

What Happens w/ Celiac Disease?

When people with Celiac disease eat Gluten, their body responds by damaging the small intestine.

The villi become damaged or destroyed.

Long Term Effects

Malabsorption resulting in deficiencies… Calcium Vitamin D Iron Folate

Anemia Bone Disease Nerve Damage Muscle Weakness Cancer

Long Term Effects

Joint Pain Anxiety Delayed Puberty Miscarriage Short Stature Easy Bruising Wt loss Fluid Retention Intestinal bloating or “potbelly”

Related Complications

Those with CD are more likely to have other autoimmune disorders

Rheumatoid arthritis

Type I Diabetes

Autoimmune Thyroid Disease

Related Complications

CD is often misdiagnosed as Irritable Bowel Syndrome In a survey of CD respondents, 37% reported

that they were initially diagnosed with IBS

Dermetitis Hepetiformis (DH) Manifestation of gluten sensitivity involving

the skin Can lead to itchy, blistering skin rash

Related Complications

Lactose Intolerance Some people with CD aren't able to tolerate

milk sugar (lactose) found in dairy products.

Intestinal damage from consuming gluten Follow lactose and gluten free diet Once intestines have healed, you may be able

to tolerate dairy products again.

What Should I Do if I Think I have Celiac Disease?

See your doctor http://www.celiaccentral.org/

“Celiac Symptoms Checklist” Symptoms of celiac disease are similar to many other conditions Small intestine biopsy Antibody test

What is the Treatment for Celiac Disease?

A 100% Gluten Free Diet Speak with a dietitian about this as well

as the possible need for a multivitamin (Iron, B-vitamins, Fiber)

There is currently no cure

Myth or Fact?

Myth or Fact?

People with celiac disease are allergic to wheat?

Myth Celiac disease is an autoimmune

disorder, not an allergy. Celiac disease is often confused for an allergic illness because (like an allergy) it requires a foreign substance to trigger it.

Myth or Fact?

If I have a normal weight, I am well nourished

Myth It is very possible to be overweight

and malnourished. Calories do not always = Nutrients.

Myth or Fact?

Untreated Celiac disease can be life threatening

Fact

Myth or Fact?

You can outgrow celiac disease Myth You can’t “outgrow” celiac disease-even

though doctors once thought you could. If you’re an adult who “had celiac disease as a child” you still have it now, even if the obvious symptoms have gone away.

Is There Anything Else?

You are more likely to have celiac disease if a close relative has it.

Fact There is a genetic component to CD

Myth or Fact?

Celiac disease is the same thing as Gluten Intolerance

Myth: Gluten intolerance is a broad term which includes all kinds of sensitivity to Gluten. However, if you have celiac disease, you have gluten intolerance.

Myth or Fact?

Gluten can be absorbed through the skin

Myth Gluten molecules are too large to be

absorbed through the skin. Skin care products are okay

Just don’t swallow Toothpaste, lipsticks, lip balms, and

any product that will be used on small children should be gluten-free

Myth or Fact

Celiac disease is linked to other autoimmune disorders, such as Type I Diabetes.

Fact: It is estimated between 1 in 20 people with type 1 diabetes also have CD.

Myth or Fact

If you think you have celiac disease, you should begin a gluten free diet

Myth: You should NOT begin the gluten-free diet before you are diagnosed. Starting the diet will affect testing for the disease.

Myth or Fact

You’ll feel better as soon as you stop eating gluten

Myth: The amount of time it takes to feel better after going gluten-free is different for every person. Some people feel the results right away, but other need weeks or months to feel results.

Questions?

VIDEO - Celiac Disease: A Life of Misdiagnosis