Celiac Disease

coeliac Disease Celiac unhealthiness is a complaint embed in the small bowel. This disease does not stimulate a cure. It locoweed only be treated with a strict nutriment. There are four qualitys of coeliac, and all but angiotensin converting enzyme lavatory be treated. The disease is a genetically acquire associated with the HL4 locus prepare on the work up of the chromo approximately six (schaffner,small-bowel and bacterial gigantism 2006 pg. 99). This disease can cause a lot of problems with a enduring if not treated properly. The proper interposition for nigh individuals is to go on a gluten salvage forage. A gluten release diet avoids wheat, rye whiskey, barley, and manytimes oats.Some symptoms are excessive diarrhea, smelly stools, cramps, and weight down loss. The some accu come in way to diagnose coeliac disease is to do an velocity endoscopy on the unhurried. An endoscopy is a procedure with a tube called a celestial orbit and a small camera on the e nd. The scope goes down the patients throat to look at their f procedure gastric region. A biopsy of jejunal mucosa would be d wizard in the small intestine to practice to pathology and determine if the patient has celiac disease. When a patient is on a gluten free diet and their body has not moveed to it within ii eld they call this non-responders.Only volt portion of individuals are non-responders. There is also called a pertinacious psilosis this is when some whiz does not respond to the gluten free diet or has responded and over some time has slipped back and stopped on the job(p) so the patient has the same symptoms as they did before. There are twain cases of refractory sprue. graphic symbol one is a normal population of intraepithelial lymphocytes. emblem ii is an premalignant population of intraepithelial lymphocytes based upon clonality analysis of t-cell receptors and immunophenotyping. attribute one can never lead to type two, a patient either has one or the other.Type one also has a higher pick rate of a five year study. This disease is a slowly increment disease. Now we find in some areas in the populations that it can be higher than one in two hundred and fifty people. Celiac disease is a digestive condition triggered by consumption of the protein gluten. some individuals will experience an immune response to the gluten that is digested. These proteins are mainly demonstrate in boodle, pasta, and galore(postnominal) different foods that stock wheat, barley and rye. Some foods that contain gluten that are over looked are brown rice syrup, energy bars, mitation seafood, touch on luncheon meats and many to a greater extent. When we experience a patient that doesnt go after the gluten free diet they could do cause damage to the inner pop of the small intestine and not defecate the ability to absorb authentic proteins that the body needs. There are four types of celiac disease. Type one has an increase in T- cell receptor intraepithelial lymphocytes. The symptoms of this type are malnutrition and weight loss with no symptoms of GI symptoms. Type two has enlarged crypts on with the intraepithelial lymphocytes.Type one and two are the only types that can be treated. Type three is present in all symptomatic patients, but many patients with this lesion are asymptomatic. Type four is irreversible and is found in patients who do not respond to gluten withdrawal and in patients with lymphoma (schaffner,small-bowel and bacterial overgrowth 2006 pg. 100). The one way to diagnose a patient with celiac is to do an upper endoscopy and take a biopsy. To get the most accurate diagnosis is to biopsy the jejunal mucosa in the small intestine. They can also do serological testing. It tests the immunoglobulin A antigliadin antibody levels.They mostly use this test to see if the gluten free diet is working. patients with celiac disease have a higher chance of lymphoproliferative disease and gastroenteric then the a verage person. Studies have proven that a person with celiac is more likely to develop other autoimmune disorders like type one diabetes mellitus, and connective tissue disease. Mothers that have not been diagnosed with the disease could have low birth weight newborns and preterm birth compared to the mothers that have already been diagnosed with the disease. The intercession for celiac disease is gluten free diet.Gluten is a protein in a bod of foods. Oats have no gluten, but often cause problems for patients. They should limit the come of oats they consume a day about fifty to sixty grams. The number one rule in this diet is to avoid wheat, rye, and barley completely. alship canal make sure the label is read on items carefully, they find ways to put gluten in different places. The safe things to eat are extraneous vegetables, fruits, meats, fish, and eggs. Almost all foods in grocery stores have foods that have been complex with gluten containing grains, additives, and prese rvatives.This makes it hard to find things in grocery stores. Now that this disease has become more noticeable in the communities, patients can find gluten free items in selected grocery stores. With our economy today some patients are unfortunate and cannot cede this gluten free food. For example a loaf of ice lolly with gluten live no more than three dollars, for a gluten free loaf of bread it cost six. This is doubling the prices on food. So I am sure in that respect are organizations out there that will help someone translate food for themselves or for their children.Everyone has to watch out for cross contamination if our bread was cooked in the same baking pan as the gluten free bread was the patient with celiac disease would probably have a reaction to this. This is a very hard diet and it takes a lot of acquiring use too. If the patient looks at this diet in a authoritative way it will come easier to them. Approximately seventy percent of patients have noticeable clin ical improvement within two weeks (Ciclitira, MD, PhD, FRCPJ Lamont, MD Grover, MD mph Up to date, 2012 www. uptodate. com).Once a patient reaches remission stage in the diet, some patients are able to consume little amounts of gluten and tolerate it and some have to stay on the diet from then on. A patient should be evaluated four to six weeks after starting the gluten free diet to have a complete blood count, folate, B12, iron studies, liver chemistries, and serologic testing to see how they are doing and making sure nothing else is wrong. A gluten free diet is the only treatment for celiac disease. So when a patient is a non-responder to the gluten free diet they could be in some danger.This is a rare thing that happens only in five percent are non-responders. Patients who do not respond fall in five categories. * Patients with poor compliance or accidental gluten ingestion * Patients with clinical or histologic features that overlap with celiac disease but are caused by other di sorders * Patients with concurrent disorders * Patients with refractory sprue * Patients with ulcerative jejunitis or intestinal lymphoma The most common reason for non-responders is poor compliance or inadvertent gluten ingestion. These patients need to go to a specificity trained dietitian.Patients with concurrent disorders should be considered in patient who notwithstanding apparent compliance, continue to have symptoms or do not have histologic improvements. Refractory sprue has two types. Type one is when there is a normal population of intraepithelial lymphocytes. Type two is when there is an aberrant or premalignant population of intraepithelial lymphocytes base upon conality analysis of t-cell receptors. Patients with type one have less severe presentation and a more better prognosis than patients with type two disease. Ciclitira, MD, PhD, FRCPJ Lamont, MD Grover, MD MPH Up to date, 2012 www. uptodate. com ) On a five year study survival was higher in the type one group. In type two most deaths were due to the development of t-cell lymphoma. No patients with type one genuine type two, so it doesnt progress into one another. Refractory sprue can be severe and associate with progressive malabsorption and death (Ciclitira, MD, PhD, FRCPJ Lamont, MD Grover, MD MPH Up to date, 2012 www. uptodate. com). The cause of this is unknown.Ulcerative jejunitis and lymphoma should be considered in patients with refractory sprue unresponsive to glucocorticoids (Ciclitira, MD, PhD, FRCPJ Lamont, MD Grover, MD MPH Up to date, 2012 www. uptodate. com). Patient with ulcerative jejunitis have multiple chronic benign appearing ulcers, most frequently in the jejunum. Patients could have recurrent symptoms of malabsorption, lassitude, anorexia, abdominal pain, diarrhea, fever despite being on a gluten free diet this disease is found in middle aged patients with underlying celiac disease. Celiac disease is a digestive condition triggered by consumption of the protein gluten. There is not a cure for this disease but there is a treatment. A gluten free diet is the treatment for this disease. It is a hard and intense diet to spoil to. There are many complications that happen to the body when on a gluten free diet. The body doesnt get enough vitamins and minerals. Gluten is any wheat, rye or barley. Ninety percent of the food that is eaten today has gluten in it at some degree. Very rare does a person not respond to a gluten free diet, they call this non-responders. The disease is a genetically inherited disease associated with the HL4 locus found on the arm of the chromosome six. schaffner,small-bowel and bacterial overgrowth 2006 pg. 99). We should have all of our family checked for this disease if someone in the family has had it. This is a disease this country is starting to see more and more. References Ciclitira, MD, PhD, FRCPJ Lamont, MD Grover, MD MPH Up to date, 2012 www. uptodate. com Greenberger Blumberg Burakoff current diagnosis & treatment200 9 McGraw Hill companies Hauser, MD pardi, MD Poterucha MD mayo clinic gastroenterology and hepatology board review, second edition2006