5.6 Celiac Disease

Jill Reid, VCU

5.6 Celiac Disease

Celiac Disease & Gluten

1 out of every 133 people in the United States has celiac disease1. People with celiac disease cannot consume the protein gluten because it causes their body to generate an autoimmune response (immune cells attack the body’s own cells) that causes damage to the villi in the intestine, as shown in Figure 5.61.

Figure 5.61 Different stages of celiac disease2

This damage to the villi impairs the absorption of macronutrients and micronutrients from food.

There are a variety of symptoms for celiac disease that vary depending on age and from person to person. For a listing of all symptoms, see the first link below. The second link describes the difficulty in diagnosing this disease, which is reinforced by the third video link.

Required Web LinkWhat are the symptoms of celiac disease?Celiac Disease, a Common, but Elusive, Diagnosis Video: Celiac’s Disease (2:00)

The symptoms can appear in infancy or much later in life, even by age seventy. Celiac disease is not always diagnosed because the symptoms may be mild. A large number of people have what is referred to as “silent” or “latent” celiac disease. Figure 5.63 demonstrates how silent and latent conditions underlie the asymptomatic nature of the condition.3

Figure 5.63 Celiac Iceberg demonstrating the silent and latent phases that may exist prior to the development of symptoms.3

Villi destruction is what causes many of the symptoms of celiac disease. The destruction of the absorptive surface of the small intestine also results in the malabsorption of nutrients, so that while people with this disease may eat enough, nutrients do not make it to the bloodstream because absorption is reduced. The effects of nutrient malabsorption are most apparent in children and the elderly as they are especially susceptible to nutrient deficiencies. Over time, these nutrient deficiencies can cause health problems. Poor absorption of iron and folic acid can cause anemia, which is a decrease in red blood cells. Anemia impairs oxygen transport to all cells in the body. Calcium and vitamin D deficiencies can lead to osteoporosis, a disease in which bones become brittle.3

What is gluten?

Gluten is a protein that is bound to starch in the endosperm of grains such as:

Wheat
Barley
Rye
Triticale

Figure 5.62 Parts of a wheat granule4

Gluten-free diets have been increasing in popularity even for people who don’t have celiac disease. The thinking among those consuming these diets is that they might be gluten-sensitive, meaning that they experience adverse effects from consuming it. However, as the following videos describes, there is not much evidence to support people being gluten-sensitive.

Required Web LinkVideo: Is Gluten-Sensitivity Real? (3:11)

Celiac disease is most common in people of European descent and is rare in people of African American, Japanese, and Chinese descent. It is much more prevalent in women and in people with Type 1 diabetes, autoimmune thyroid disease, and Down and Turner syndromes.

Symptoms can range from mild to severe and can include pale, fatty, loose stools, gastrointestinal upset, abdominal pain, weight loss and, in children, a failure to grow and thrive.3

References & Links

http://www.celiac.org/
http://en.wikipedia.org/wiki/File:Coeliac_Disease.png
https://2012books.lardbucket.org/books/an-introduction-to-nutrition/
http://en.wikipedia.org/wiki/File:Wheat_seed.jpg

Links

What are the symptoms of celiac disease? – http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/#symptoms Celiac Disease, a Common, but Elusive, Diagnosis –

http://well.blogs.nytimes.com/2014/09/29/celiac-disease-diagnosis-gluten/