Celiac disease, also referred to as celiac sprue or gluten-sensitive enteropathy, is a digestive tract ailment characterized by an inability to tolerate gliadin, soluble gluten portion. Gluten is a protein found in rye, wheat, and barley, among other grains. Gluten induces inflammation in the intestines in people who have celiac disease. The small intestine is gradually damaged by repeated exposure, which might result in issues absorbing nutrients and minerals from food. Celiac disease affects about one in every 100 individuals worldwide, and many people are unaware that they have it. Celiac disease goes undiagnosed in up to 2.5 million persons in the United States.
Celiac Disease: What Causes It?
Gluten causes the immune system to attack the villi in celiac disease. Villi (VIL-eye) are finger-like extensions that line the small intestine and collect nutrients from food before transporting them to circulation. Villi that have been damaged are unable to ingest the minerals and vitamins that a youngster requires to thrive. Celiac disease has an unknown cause. It runs in families, therefore a child with a family history of the disease is more likely to develop it. Other illnesses, such as Williams syndrome, Down syndrome, type 1 diabetes, and autoimmune thyroid disorders, can also cause it.
How can you know if you have celiac disease?
Celiac disease symptoms vary from person to person and include:
- Hepatitis or unexplained anaemia.
- Dermatitis herpetiformis, a severe blistering skin rash, and mouth sores.
- Digestive issues, Mouth ulcers, Headaches, and fatigue
- Muscle spasms, joint and bone discomfort, and tooth enamel abnormalities are all common musculoskeletal issues.
- Weight loss, Nausea, and vomiting
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Diagnosis of Celiac Disease
A doctor can often identify celiac disease by looking at the patient’s and family’s medical histories and ordering various tests.
- Blood Test: Your blood sample will be tested to see how many infection-fighting cells (antibodies) you have in your blood when it comes to gluten. Certain antibodies are often increased in celiac disease patients.
- Biopsy: To assess for damage to the villi, a tissue sample is collected from your small intestine. A long, thin tube is inserted into your mouth, down through your stomach, and into your small intestine to do this. Tools are passed through the tube to obtain a tissue sample and the sample is examined.
- Bone Density Testing: If you have celiac disease, your doctor will most likely suggest a bone density test. A scanning machine, comparable to an X-ray, is used in this exam.
- Genetic Testing: A genetic test may be ordered by your doctor to rule out a celiac disease diagnosis.
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The changing trend of celiac disease
There have been considerable changes in the diagnosis, aetiology, and natural history of this disorder in recent years, with celiac disease going through a true ‘metamorphosis’ due to the continual growth in the number of diagnoses discovered, even in senior patients. This is mostly due to the increased accessibility of high sensitivity and specificity screening tests, which allows for the identification of celiac disease risk groups and have resulted in a major increase in diagnoses globally.
During the first few years of life, Celiac disease is typically manifested by diarrhoea and failure to thrive. Small intestinal biopsy abnormalities are used to diagnose celiac disease; however, serologic markers with high precision for disease sensitivity and selectivity, such as IgA antibodies to tissue transglutaminase, can be used to screen for celiac disease (TG). With the introduction of quick screening tools and increased awareness of the celiac disease, more people who would otherwise be asymptomatic (or have subclinical symptoms) are being identified. Celiac disease manifests itself in a wide range of clinical signs that are no longer limited to the gastrointestinal system.
Novel therapeutic approaches for celiac disease
The increasing understanding of pathogenesis has provided a number of new intervention targets. Several of the novel treatments have progressed to clinical trials.
- Two of the therapies try to keep gluten from interacting with the mucosal immune system: oral enzyme supplementation to speed up the breakdown of gluten into non-immunostimulatory pieces, or the use of a polymer to sequester the gluten proteins.
- Making modified grains devoid of immunostimulatory sequences is one strategy that also addresses the gluten antigen itself.
- Another technique tries to treat a celiac disease-related epithelial barrier deficiency.
- It’s also possible to treat celiac disease by preventing gluten-reactive CD4+ T cells from activating.
- In addition, a phase II clinical trial in celiac disease is currently underway to see if an intestinal hookworm infection alters the local immune response mode and suppresses gluten sensitivity in celiac disease patients.
Although therapies to reduce gluten exposure, alter intestinal permeability, and adjust immune activation are promising new treatments for celiac disease, a gluten-free diet has almost no negative effects. For celiac patients, the gluten-free diet remains the best and safest therapeutic option. Once celiac disease has been diagnosed, the only treatment option is to follow a gluten-free diet for the rest of one’s life. Any new treatment must have the same level of safety as the gluten-free diet. The US Food Administration announced a new definition for “gluten-free” for food labelling purposes in August 2013. To be called gluten-free, a food must contain no more than 20 parts per million (ppm) of gluten, according to the FDA. Clinicians and patients would not tolerate therapies that resulted in a rise in infection, malignancy, or severe gastrointestinal side effects.