Celiac Disease

Celiac Disease, also known as “wheat allergy”, is being increasingly diagnosed and coming into focus because of its deleterious effects on several aspects of health.

What is Celiac Disease? Celiac Disease (CD) is a condition in which the body reacts to a protein, called gluten, present in wheat and wheat products. As the point of contact with ingested gluten occurs in the small intestine, it is here that the major immunological damage occurs, resulting in impaired digestion of food and absorption of nutrients.

How common is it?

With increasing awareness, CD is being diagnosed with frequently. Experts estimate that up to 1% of the wheat eating population may have CD.

In whom does it occur and how does one suspect CD?

There are 2 forms of CD: the childhood form and the adult form.

The childhood form presents after a few months or years of weaning and introduction to wheat based foods, and manifests as loose motions, weakness, stunted growth and failure to thrive.

The adult form manifests in several ways: frequent loose motions, short stature or stunting, iron deficiency anaemia, weak bones, low levels of iron or calcium in the blood, frequent spasms of fingers or toes, cramps, diabetes in early age or liver disorder. Some may also present to the dermatologist with scratchy skin lesions.

How is the diagnosis of CD made?

A high index of suspicion is needed. A simple blood test called tissue trans-glutaminase (TTG) or Anti-endomyceal antibody is usually positive. An endoscopic examination during which a biopsy is obtained from the duodenum (upper part of small intestine) helps in confirming the diagnosis as well as in grading the disease, that is, tells how severe the intestinal damage is.

Which adults should undergo screening tests for CD?

Any person with frequent bowel upsets, loose stools, short stature, anaemia, weak bones or muscles, abnormal liver function tests, diabetes in early age, or an itchy skin condition called dermatitis herpetiformis should undergo evaluation. Also, blood relations of a patient with CD should be screened as CD tends to run in families.

Is it a treatable condition?

If diagnosed early, patients with CD can attain and maintain perfectly normal health. They need to be on a gluten free diet all through their lives. On stopping wheat and other food items that contain gluten, they show remarkable clinical improvement with rapid weight gain and correction of malabsorption and disordered metabolism. Some patients with a severe form of the disease need medications that suppress their deranged immune system. Supplements of iron and calcium are often required. Patients of untreated CD run the risk of developing cancer of the small intestine.

As published in HT City ( Hindustan Times) dated 7th April, 2013.