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Celiac Disease : Symptoms, Causes, Treatment and Prevention

Celiac disease is an autoimmune disease that results from consuming gluten. In celiac disease, the immune system will react after consuming gluten, which can damage the lining of the small intestine and inhibit the absorption of nutrients (malabsorption of nutrients). As a result, people with celiac disease will experience diarrhea, weakness, or anemia.

Gluten itself is a protein that can be found in several types of cereals, such as wheat. Some examples of foods containing cereals are pasta, cakes, breakfast cereals, certain sauces or soy sauce, bread, and some types of instant foods. Gluten functions to make bread dough or other foods become elastic and supple.

There is no cure for celiac disease. However, applying a gluten-free diet can help relieve symptoms and cure the intestine.

Symptoms of Celiac Disease

Symptoms of celiac disease do not only occur in the digestive system. Some other body parts can also show symptoms. In children the symptoms of celiac can be:

  • easily tired
  • easy to get angry
  • smaller than peers
  • late puberty
  • weight loss
  • gag
  • stomach upset
  • abdominal pain
  • diarrhea or persistent constipation
  • feces that are pale, fatty and foul-smelling

In adults the symptoms of celiac can be:

  • iron-deficiency anemia
  • joint pain and stiffness
  • weak and brittle bones
  • weak
  • seizure
  • skin disorders such as dermatitis herpetiformis
  • tingling and numbness in the hands and feet
  • tooth discoloration or loss of enamel
  • a wound in the mouth
  • irregular menstruation
  • infertility and miscarriage

Dermatitis herpetiformis occurs in about 25% of people with celiac disease. Patients usually do not experience symptoms of the digestive system. Patients usually experience a skin rash consisting of small lumps and itchy blisters. Generally, dermatitis herpetiformis appears on the elbows, buttocks, and knees.

Causes and Risk Factors of Celiac Disease

Celiac is not allergic or body intolerance to gluten. This disease is an autoimmune condition, in which the body misidentifies the compounds contained in gluten as a dangerous threat and instead forms antibodies to overcome them, thus attacking healthy body tissues. In the case of celiac, antibodies make the small intestine become inflamed and swollen. These antibodies will make fine hairs (villi) on the intestinal surface become damaged so that the process of absorption of nutrients from food becomes imperfect. In addition, in most celiac sufferers there are also genetic disorders that can cause cell changes in the small intestine.




Until now the exact cause of the celiac disease is unknown, but a combination of autoimmune processes and genetic disorders, as well as the effects of other conditions, such as undergoing surgical procedures, pregnancy, and childbirth, viral infections, or severe emotional disorders, are thought to be the cause of celiac disease.

The following are some of the factors that can increase a person's risk of suffering from the celiac disease:

  • Heredity factor. If you have family members who suffer from celiac disease, the risk of experiencing a similar disease is also greater.
  • Environmental factor. Someone who has had a digestive system infection while still a child, for example, a rotavirus infection, will have a greater risk of developing celiac disease
  • Health condition. Type 1 diabetes, ulcerative colitis, nervous disorders, Down syndrome, the syndrome can increase the risk of developing celiac disease.

Diagnosis of Celiac Disease

The doctor will determine the diagnosis of celiac disease from detailed medical interviews about symptoms and physical examination. The investigation is also needed to confirm the diagnosis.

Blood tests usually show high anti-endomysium (EMA) and anti-tissue transglutaminase (TGA) antibodies. The examination is carried out when people consume gluten.

Other tests include an examination of liver function, cholesterol, alkaline phosphate, and serum albumin. A skin biopsy examination may be needed in patients who also have dermatitis herpetiformis. If the diagnosis still cannot be confirmed, an endoscopic examination can be done to take the intestinal biopsy.

Treatment of Celiac Disease

To treat celiac disease, doctors will usually advise people to avoid all foods or ingredients that contain gluten by running a gluten-free diet program. This is done to prevent damage to the intestinal wall, as well as symptoms of diarrhea and abdominal pain. Doctors will also recommend a balanced diet where all the nutrients your body needs can be fulfilled. In addition to food, gluten can also be found on drugs, vitamins, and even lipstick.

Some natural gluten-free foods that can be consumed are meat and fish, vegetables and fruit, milk and dairy products such as cheese and butter, potatoes, and rice. Some types of flour are gluten-free, such as rice flour, cornflour, soy flour, and potato flour. Breast milk and most infant formula are also free of gluten.

In addition to a gluten-free diet, several additional therapies are needed to help treat symptoms and prevent complications. These therapies include:

  • In some cases, celiac disease can cause the spleen to work less effectively so that patients are susceptible to infection. Therefore, patients need additional vaccinations, such as flu vaccine, Haemophilus influenza type B vaccine, meningitis vaccine, and pneumococcal vaccine, to protect patients from infection.
  • This therapy is needed to ensure the sufferer gets all the nutrients needed. The supplements needed are calcium, folic acid, iron, vitamin B12, vitamin D, vitamin K, and zinc.
  • This drug is needed when intestinal damage is very severe, to relieve symptoms during the healing process of the intestine.
  • This drug is used so that symptoms subside more quickly. The dapsone drug dosage given is usually very small, considering it can cause side effects of headaches and depression.

After a gluten-free diet and several therapies, patients need to check themselves regularly to ensure that the diet and therapy produce results as expected. An examination usually done through this blood test will determine whether a gluten-free diet needs to be continued or not. If symptoms continue or relapse, an endoscopic examination with biopsy is necessary. After several weeks of undergoing a gluten-free diet, usually the patient's condition has improved, but healing the entire digestive system can take as long as 2 years.

Complications of Celiac Disease

If celiac disease is not treated or continues to eat foods that contain gluten, then there are some complications that can be experienced by sufferers, namely:

  • Malabsorption and malnutrition. The patient's body cannot absorb nutrients perfectly, which can lead to iron-deficiency anemia, osteoporosis, weight loss, and stunted growth. In this condition, there will also be symptoms of weakness, dizziness, or appearing confused
  • Infertility and miscarriage. Lack of calcium and vitamin D can cause interference with the reproductive organs.
  • Lactose intolerance. Patients will be at risk for lactose intolerance because their body lacks the enzyme to digest lactose, which is usually found in dairy products such as cheese, milk, or yogurt.
  • People with celiac disease have a greater risk of colon cancer and intestinal lymphoma.
  • Low birth weight baby. This risk is higher in pregnant women with uncontrolled celiac disease.

Prevention of Celiac Disease

There is no precautionary measure against the celiac disease that can be done because it is caused by an immune system abnormality. Preventing symptoms can be done by avoiding foods that contain gluten.

Some types of foods that are safe for consumption by celiac sufferers include vegetables such as corn, spinach, and potatoes. Some types of beans such as soybeans can also be consumed. Other choices are corn flour, corn tortillas, rice, quinoa, and fruit.

People with celiac disease can also eat fresh meat, poultry such as chicken, fish, and dairy products. Drinks such as wine, cider, and distilled drinks are also quite safe for consumption by sufferers of this disease.



References

References

1. Mayo Clinic (2018). Disease and Conditiions. Celiac Disease.

2. National Institute of Diabetes and Digestive and Kidney Disease. Celiac Disease.

3. NHS Choices UK (2016). Health A-Z. Coeliac Disease. 


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