Celiac disease overview: Difference between revisions
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==Differentiating Celiac Disease from other Diseases== | ==Differentiating Celiac Disease from other Diseases== | ||
Celiac disease must be differentiated from other diseases presenting as [[chronic diarrhea]]. Common differntials of celiac disease include [[lactose intolerance]], [[cystic fibrosis]], [[Crohns disease]], [[laxative| laxative overuse]], [[hyperthyroidism]] and [[irritable bowel syndrome]]. | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
Revision as of 12:00, 13 September 2017
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Diagnosis |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
American Gastroenterological Association (AGA) Definition: “Chronic malabsorptive disorder of the small intestine caused by exposure to dietary gluten in genetically predisposed individuals”
Celiac disease is an autoimmune disorder of the small bowel that occurs in genetically predisposed people of all ages from middle infancy. Symptoms include chronic diarrhoea, failure to thrive (in children) and fatigue, but these may be absent and symptoms in all other organ systems have been described. It is estimated to affect about 1% of Indo-European populations, although significantly underdiagnosed. A growing portion of diagnoses are being made in asymptomatic persons as a result of increasing screening.[1]
Historical Perspective
Classification
Celiac disease (CD) may be classified according to the symptoms and laboratory findings into 5 sub groups as, classical, atypical, asymptomatic, latent, and potential CD.
Pathophysiology
Celiac disease is caused by a reaction to gliadin, a gluten based protein found in wheat (and similar proteins of the tribe Triticeae which includes other cultivars such as barley and rye). Upon exposure to gliadin, the enzyme tissue transglutaminase modifies the protein, leading to activation of the immune system. The immune system in turn cross-reacts with the bowel tissue, causing an inflammatory reaction. The result is flattening of the lining of the small intestine, which interferes with the absorption of nutrients. The only effective treatment is a lifelong gluten-free diet. Gluten may cause symptoms in people without celiac disease.
Causes
The common causes of celiac disease are autoantibodies to gluten and certain genetic factors.
Differentiating Celiac Disease from other Diseases
Celiac disease must be differentiated from other diseases presenting as chronic diarrhea. Common differntials of celiac disease include lactose intolerance, cystic fibrosis, Crohns disease, laxative overuse, hyperthyroidism and irritable bowel syndrome.
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT Scan
Echocardiography or Ultrasound
Other Imaging Findings
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Future or Investigational Therapies
References
- ↑ van Heel D, West J (2006). "Recent advances in coeliac disease". Gut. 55 (7): 1037–46. PMID 16766754.