CELIAC DISEASE

Celiac disease ( also known as gluten sensitive enteropathy, celiac sprue, nontropical sprue) is a condition in which the immune system reacts abnormally to a protein called gluten which  is found in wheat, rye and barley. In celiacs exposure to gluten damages the inner lining of the small intestine causing malabsorption.
Genetic factors are  important since celiac disease occurs primarily in certain groups of people, specifically whites of northern European ancestry. People who inherit specific genes that regulate the immune response (HLA DQ2 and HLA DQ8) have a higher risk of celiac disease than people without these genes

Overall prevalence is approximately 1 in 125 to 250 people in the United States.

SYMPTOMS 

Anemia
Abdominal discomfort
Excessive gas
Diarrhea
Weight loss
Osteoporosis
Short stature
Mood problems
Symptoms due to nutrient malabsorption of iron, folic acid, vitamin B12, calcium, vitamin D, or vitamin K.

Associated conditions include

Dermatitis herpetiformis
Neuropsychiatric problems
Down syndrome
Selective IgA deficiency
Type I diabetes mellitus
Thyroid disease
Infertility
Cardiomyopathy
Myocarditis
Arthritis
Kidney disease
Glossitis
Pancreatitis
Liver disease.

Complications of Celiac disease include

Refractory sprue
Lymphoma

DIAGNOSIS 

Celiac disease can be difficult to diagnose because the signs and symptoms are similar to other gut ailments.
Blood tests -IgA tissue transglutaminase antibody levels are high in > 98 % of patients with this disease.
Before having this test, it is important to eat a normal diet, including foods that contain gluten.
Endoscopy reveals loss of proximal small bowel  folds, visible fissures, nodular or mosaic appearance or the folds may be scalloped.
Small intestine biopsy shows loss of villi.

TREATMENT

Complete elimination of gluten (wheat, rye, and barley) is the mainstay of treatment.
Oats should be avoided unless the package specifically indicates that the product is gluten free and was processed in a gluten free facility. Soybean or tapioca flours, rice, corn, buckwheat, and potatoes are safe.
For more information please see
www.nlm.nih.gov/medlineplus/healthtopics.html    
www.celiac.org
www.csaceliacs.org 
www.celiac.com   
www.glutenfree.com/
www.gfutah.org