Overview<\/span><\/p>\n

Celiac Sprue is most commonly called Celiac Disease (CD) but may also be referred to as non-tropical sprue or gluten sensitive enteropathy.\u00a0 It is a lifelong auto-immune disorder in which the digestive tract adversely reacts to gluten.\u00a0 It is not a food allergy.\u00a0\u00a0 Once considered a rare childhood disease, CD is now thought to affect approximately one out of every 133 people in the United States.<\/p>\n

When a person with CD eats food that contains gluten, it goes through their digestive tract causing damage to the lining of the small intestine.\u00a0 Since the main job of the small intestines is to absorb nutrients from food, many patients suffering from CD may become malnourished.<\/p>\n

Symptoms<\/span><\/p>\n

Celiac sprue affects each patient differently.\u00a0 Some patients may not have any noticeable symptoms, but their blood tests may show vitamin and mineral deficiencies.<\/p>\n

Children are more likely to experience digestive tract symptoms.\u00a0 These include:<\/p>\n

\n
• Nausea or lack of appetite<\/li>\n
• Chronic diarrhea or constipation<\/li>\n
• Foul-smelling or fatty stool<\/li>\n
• Vomiting<\/li>\n
• Abdominal bloating and pain<\/li>\n
• Excessive gas<\/li>\n
• Weight loss<\/li>\n
• Irritability<\/li>\n<\/ul>\n

  Over time, the decreased absorption of nutrients in children can cause delayed growth and short stature, delayed puberty, and dental problems.\u00a0 Infants suffering from CD may be diagnosed with failure to thrive.<\/p>\n

  Adults with CD may experience digestive tract symptoms but are also more likely to have symptoms that are more widespread.\u00a0 These include:<\/p>\n

  \n
  • Tiredness<\/li>\n
  • Depression<\/li>\n
  • Anxiety<\/li>\n
  • Arthritis<\/li>\n
  • Osteopenia or osteoporosis<\/li>\n
  • Bone or joint pain<\/li>\n
  • Tingling or numbness in hands and feet<\/li>\n
  • Missed menstrual periods<\/li>\n
  • Infertility or recurrent miscarriages<\/li>\n
  • Canker sores\/mouth ulcers<\/li>\n
  • Skin rash (dermatitis herpetiformis)<\/li>\n
  • Seizures<\/li>\n
  • Anemia<\/li>\n<\/ul>\n

    Common Nutrient Deficiencies in Celiacs<\/p>\n

    -Minerals<\/p>\n

    \n
    • Calcium<\/li>\n
    • Copper<\/li>\n
    • Iron<\/li>\n
    • Magnesium<\/li>\n
    • Phosphorous<\/li>\n
    • Potassium<\/li>\n
    • Selenium<\/li>\n
    • Zinc<\/li>\n<\/ul>\n

      -Vitamins<\/p>\n

      \n
      • Vitamins A, D, E, and K<\/li>\n
      • Folic Acid<\/li>\n
      • Vitamin B 1, 2, 3, 6, 9, 12<\/li>\n
      • Vitamin C<\/li>\n<\/ul>\n

        Lactose Intolerance<\/p>\n

        Newly diagnosed patients may also be lactose intolerant.\u00a0 This means that their body is unable to break down and digest lactose, a sugar found in milk products due to a deficiency in the lactase enzyme.\u00a0 This will lead to symptoms like bloating, cramping, abdominal discomfort, gas, and diarrhea 30 minutes to 2 hours after consuming milk products.\u00a0 For most patients, this problem will go away once a gluten-free diet is started and the lining of the small intestines has time to heal.<\/p>\n

        Cause\/Risk Factors<\/span><\/p>\n

        The exact cause of CD is not fully understood.\u00a0 Patients with other genetic disorders (Down Syndrome, Turner Syndrome) and auto-immune disorders (Type 1 Diabetes, Rheumatoid Arthritis, Lupus, auto-immune thyroid disease) are at an increased risk of developing CD.\u00a0 Patients with celiac disease should suggest that first-degree relatives (parents, children, or siblings) get tested because there is a 1 in 22 chance that they may develop CD in their lifetime.<\/p>\n

        Testing<\/span><\/p>\n

        Once celiac sprue is suspected, the doctor should order a blood test.\u00a0 It is very important that the patient continues with their normal diet during evaluation and testing.\u00a0 The blood test ordered will measure specific autoantibodies (proteins that react against the body\u2019s own cells).\u00a0 For a possible diagnosis of celiac disease, these three proteins may appear at higher levels than normal:<\/p>\n

        \n
        • EMA-anti-endomysial<\/li>\n
        • TTG-anti-tissue transglutaminase<\/li>\n
        • DGP-deaminated gliadin peptide<\/li>\n<\/ul>\n

          Blood tests may also be ordered to measure vitamins and minerals that would appear at lower levels than normal due to poor absorption and malnutrition from the damage to the lining of the small intestines.<\/p>\n

          If the blood tests suggest CD, the doctor will then order an endoscopy with biopsy of the small intestine.\u00a0 An endoscopy is a test where a tiny camera is inserted in the mouth and moved through the digestive system so the doctor can look at the tissue for any damage.\u00a0 During this procedure, a small amount of tissue in the upper small intestines will be removed and sent to the laboratory for examination.\u00a0 This test may need to be repeated several weeks later to confirm the diagnosis and ensure that healing has begun.<\/p>\n

          Treatment<\/span><\/p>\n

          The only treatment for CD is a completely gluten-free diet.\u00a0 Once all gluten products are removed from the diet, the patient will start to feel better after about two weeks.\u00a0 Complete healing of the lining of the small intestines may take six to twelve months or longer.\u00a0 It is very important to continue a strict gluten-free diet for life to avoid any effects from long-term malnutrition (gall bladder and pancreatic insufficiency, gastrointestinal cancers, nervous system disorders).<\/p>\n

          Gluten-Free Diet<\/span><\/p>\n

          Gluten is a protein found in foods that contain wheat, rye, or barley.\u00a0 These ingredients are found in most bread, pasta, cereal, beer, and processed foods.\u00a0 Several of these items are now specially manufactured to be gluten-free and have helped make living with celiac disease more manageable.\u00a0 Some patients with CD may be more sensitive to oats, so talking with a doctor or dietician before eating oat products is suggested.\u00a0 Learning how to read food labels properly is a very important first step once diagnosed with celiac disease.\u00a0 A dietician who specializes in nutrition for patients with celiac disease will be able to suggest food to avoid and nutrient rich food that would be beneficial in the diet.\u00a0 There are also support groups available for patients with celiac disease.<\/p>\n

          Gluten-containing grains to avoid:<\/p>\n

          \n
          • Barley, barley malt, barley extract<\/li>\n
          • Bran<\/li>\n
          • Bulgur<\/li>\n
          • Couscous<\/li>\n
          • Durum<\/li>\n
          • Einkorn<\/li>\n
          • Emmer<\/li>\n
          • Farina<\/li>\n
          • Faro<\/li>\n
          • Graham flour<\/li>\n
          • Kamut<\/li>\n
          • Matzo flour\/meal<\/li>\n
          • Orzo<\/li>\n
          • Panko<\/li>\n
          • Rye<\/li>\n
          • Seitan<\/li>\n
          • Semolina<\/li>\n
          • Spelt<\/li>\n
          • Triticale<\/li>\n
          • Udon<\/li>\n
          • Wheat, wheat bran, wheat germ, wheat starch<\/li>\n<\/ul>\n

            Other Products Containing Gluten<\/span><\/p>\n

            There are several non-food products that contain gluten that should be avoided.\u00a0 These include certain lipstick, lip balm, lip gloss, play dough, herbal supplements, over the counter medications, vitamins, minerals, and prescription medications.\u00a0 A pharmacist can help find information about whether specific OTC or prescription medications contain gluten.\u00a0 If the information is left off a product label, sometimes a call to the manufacturer may be needed to find out for certain if the product is gluten-free and safe to use.<\/p>\n

            A New Lifestyle<\/span><\/p>\n

            With practice, choosing gluten free foods and products will become easier.\u00a0 It may seem like a huge burden at first, but it is important to remember that avoiding gluten completely is the only way the body will heal and absorb nutrients.\u00a0 It is important for those close to the patient to be educated on the disease so they are able to help support the new lifestyle.\u00a0 There are several resources available to learn more about Celiac Disease.<\/p>\n

            http:\/\/www.celiac.org\/index.php<\/a>
            \nhttp:\/\/www.csaceliacs.info\/index.jsp<\/a>
            \nhttp:\/\/www.uptodate.com\/contents\/celiac-disease-in-adults-beyond-the-basics<\/a>
            \nhttp:\/\/www.gastrokids.org\/files\/documents\/resources\/Gluten-FreeDietGuideWeb.pdf<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

            Overview Celiac Sprue is most commonly called Celiac Disease (CD) but may also be referred to as non-tropical sprue or gluten sensitive enteropathy.\u00a0 It is a lifelong auto-immune disorder in which the digestive tract adversely reacts to gluten.\u00a0 It is not a food allergy.\u00a0\u00a0 Once considered a rare childhood disease, CD is now thought to […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[17],"tags":[],"_links":{"self":[{"href":"http:\/\/medicineshoppenorton.us\/wp-json\/wp\/v2\/posts\/365"}],"collection":[{"href":"http:\/\/medicineshoppenorton.us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/medicineshoppenorton.us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/medicineshoppenorton.us\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/medicineshoppenorton.us\/wp-json\/wp\/v2\/comments?post=365"}],"version-history":[{"count":13,"href":"http:\/\/medicineshoppenorton.us\/wp-json\/wp\/v2\/posts\/365\/revisions"}],"predecessor-version":[{"id":378,"href":"http:\/\/medicineshoppenorton.us\/wp-json\/wp\/v2\/posts\/365\/revisions\/378"}],"wp:attachment":[{"href":"http:\/\/medicineshoppenorton.us\/wp-json\/wp\/v2\/media?parent=365"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/medicineshoppenorton.us\/wp-json\/wp\/v2\/categories?post=365"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/medicineshoppenorton.us\/wp-json\/wp\/v2\/tags?post=365"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}