Could be Celiac Disease, an autoimmune disease in which the body cannot process gluten, a protein in wheat, rye and barley (i.e. Beer) that 1 in 133 ppl have. Please read the info below for more info and testing but if you want to get tested DO NOT go on the gluten free diet first. See your doc bc you MUST be eating gluten before the testing for it to be accurate.
Amy
Chairperson Louisiana North Shore Celiac Sprue Association
What is Celiac Disease?
Celiac disease (CD) is a genetic disorder. In people with CD, eating certain types of protein, called gluten, sets off an autoimmune response that causes damage to the small intestine. This, in turn, causes the small intestine to lose its ability to absorb the nutrients found in food, leading to malnutrition and a variety of other complications.
The offending protein, gluten, is found in wheat, barley, rye, and to a lesser extent, oats (WBRO). Related proteins are found in triticale, spelt, kamut. Refer to grains and flours Glossary for a more extensive list of both safe and offending grains.
Celiac Disease is:
· a genetic, inheritable disease.
· linked to genetically transmitted histocompatibility cell antigens (HLA DR3-DQ2, DR5/7 DQ2, and DR4-DQ8).
· COMMON. Approximately 1 in 133 people have CD, however, only about 3% of these have been diagnosed. This means that there are over 2.1 million undiagnosed people with celiac disease in the United States.
· characterized by damage to the mucosal lining of the small intestine which is known as villous atrophy.
· responsible for the malabsorption of nutrients resulting in malnutrition.
· linked to skin blisters known as dermatitis herpetiformis (DH).
· not age-dependent. It may become active at any age.
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Celiac Disease is NOT:
· simply a food allergy.
· an idiosyncratic reaction to food proteins (mediated by IgE).
· typified by a rapid histamine-type reaction (such as bronchospasm, urticaria, etc.).
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The Damaging Proteins
The term "gluten" is, in a sense, a generic term for the storage proteins that are found in grains. In reality, each type of protein - gliadin in wheat, secalin in rye, hordein in barley, avenin in oats, zein in corn and oryzenin in rice - is slightly different from the others. The "gluten" in wheat, rye, barley, and in a much lower amount, oats, contains particular amino acid sequences that are harmful to persons with celiac disease. The damaging proteins are particularly rich in proline and glutamine (especially the amino acid sequences which are in the following orders: Pro-Ser-Gln-Gln and Gln-Gln-Gln-Pro). As peptides, some such as 33-MER, cannot be broken down any further. In people with celiac disease, 33-MER stimulates T-cells to produce antibodies. The antibodies, in turn, attack the villi in the small intestine, reducing their ability to absorb nutrients. It is important to note that these sequences are NOT found in the proteins of corn and rice.
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The Nature of the Injury
The damage to the small intestine (the jejunum) caused by this disease is very slow to develop and is insidious. It is:
· almost certainly mediated by the immune system.
· associated with ANTIBODIES to gliadin, reticulin and/or endomysial (smooth muscle) proteins.
· probably not directly caused by the antibodies, though they may be signals for cell-mediated immunity.
· probably produced by the cellular immune system (T cells) - but only when gluten-type prolamins are present.
· reversible, in most cases, to completely normal bowel function, if the injurious protein is excluded from the diet.
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How Does One "Catch" Celiac Disease?
Celiac disease cannot be "caught," but rather the potential for CD may be in the body from birth. Its onset is not confined to a particular age range or gender, although more women are diagnosed than men. It is not known exactly what activates the disease, however three things are required for a person to develop CD:
· A genetic disposition: being born with the necessary genes. The Human Leukocyte Antigen (HLA) genes specifically linked to celiac disease are DR3, DQ2 and DQ8.
· A trigger: some environmental, emotional or physical event in one’s life. While triggering factors are not fully understood, possibilities include, but are not limited to adding solids to a baby’s diet, going through puberty, enduring a surgery or pregnancy, experiencing a stressful situation, catching a virus, increasing WBRO products in the diet, or developing a bacterial infection to which the immune system responds inappropriately.
· A diet: containing WBRO, or any of their derivatives.
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Summary
Celiac disease is life-long and currently incurable. The only known treatment at this time is strict adherence to a gluten-free lifestyle, free of WBRO.
How is Celiac Disease Diagnosed?
When working with a physician to diagnose and/or confirm celiac disease (CD), three major steps are taken. First, a thorough physical examination is conducted, including a series of blood tests, sometimes referred to as the Celiac Blood Panel. Second, a duodenal biopsy is performed with multiple samples from multiple locations in the small intestine. And third, the gluten-free diet is implemented. When the patient shows a positive response to the diet - symptoms subside and the small intestine returns to its normal, healthy state - the diagnosis of CD is confirmed.
(NOTE: To ensure the most accurate and timely diagnosis, the gluten-free diet should be implemented only after the first two steps have been completed.)
1: Examination
Patient History
When reviewing a patient's medical history and symptoms with a physician, the following areas should be considered in the discussion: (The first three are applicable to adults and children. The last is specific to children.)
· What are the symptoms? How long have they been present? How often do they occur?
· What is the patient's emotional state? Is it consistent throughout the day? When and for how long do the symptoms occur?
· What else is involved? Other diseases? Other organs?
· How is the child developing?
See What are the Symptoms of Celiac Disease? for a thorough list of possible symptoms.
Physical Examination
Depending on the presentation of symptoms, the physician will check for some of the following items:
· emaciation
· pallor (due to anemia)
· hypotension (low blood pressure)
· edema (due to low levels of protein, [albumin] in the blood)
· dermatitis herpetiformis (skin lesions)
· easy bruising (lack of vitamin K)
· bone or skin and mucosa membrane changes due to vitamin deficiencies
· protruding or distended abdomen (intestine dysmotility)
· loss of various sensations in extremities including vibration, position and light touch (vitamin deficiency)
· signs of severe vitamin/mineral deficiencies which may include: · -diminished deep tendon reflexes
· muscle spasms (magnesium and/or calcium deficiency)
· bone tenderness and bone pain (due to osteomalacia)
Blood Tests
A number of tests, sometimes collectively referred to as the Celiac Blood Panel, will aid the physician in diagnosis. The tests may include, but are not limited to:
· Serologic Tests
1. EMA (Immunoglobulin A anti-endomysium antibodies)
2. AGA (IgA anti-gliadin antibodies)
3. AGG (IgG anti-gliadin antibodies)
4. tTGA (IgA anti-tissue transglutaminase)
· Tolerance or Measure of Digestion/Absorption Tests
1. Lactose tolerance test.
2. D-Xylose test.
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2: Biopsy
In the event that clinical signs and laboratory tests indicate probable malabsorption, a biopsy of the small intestine [jejunal] is called for. In this test, a small flexible biopsy instrument is passed through a tube, down the throat, through the stomach and into the upper end of the small intestine where patchy, multiple snippets of tissue are gathered. The tube is removed and the tissue samples are examined under a microscope for signs of injury.
2007-05-26 03:38:01
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answer #7
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answered by Glutenfreegirl 5
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