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Coeliac disease
From Wikipedia, the free encyclopedia
Coeliac disease |
Classification and external resources |

Biopsy of small bowel showing coeliac disease manifested by blunting of villi, crypt hyperplasia, and lymphocyte infiltration of crypts |
ICD-10 |K90.0 |
ICD-9 | 579.0 |
OMIM | 212750 |
DiseasesDB | 2922 |
MedlinePlus | 000233 |
eMedicine | med/308 ped/2146radio/652 |
MeSH | D002446 |
Coeliac disease ( /ˈsiːli.æk/; spelled celiac disease in North America[1]) is an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages from middle infancy onward. Symptoms includechronic diarrhoea, failure to thrive (in children), and fatigue, but these may be absent, and symptoms in other organ systems have been described. A growing portion of diagnoses are being made in asymptomatic persons as a result of increased screening;[2] the condition is thought to affect between 1 in 1,750 and 1 in 105 people in the United States.[3] Coeliac disease is caused by a reaction to gliadin,a prolamin (gluten protein) found in wheat, and similar proteins found in the crops of the tribe Triticeae (which includes other common grains such as barley and rye). Upon exposure to gliadin, and specifically to three peptides found in prolamins,[4] the enzyme tissue transglutaminasemodifies the protein, and the immune system cross-reacts with the small-bowel tissue, causing an inflammatory reaction. That leads toa truncating of the villi lining the small intestine (called villous atrophy). This interferes with the absorption of nutrients, because the intestinal villi are responsible for absorption. The only known effective treatment is a lifelong gluten-free diet.[5] While the disease is caused by a reaction to wheat proteins, it is not the same as wheat allergy.
This condition has several other names,including: cœliac disease (with œ ligature), c(o)eliac sprue, non-tropical sprue, endemic sprue, gluten enteropathy or gluten-sensitive enteropathy, and gluten intolerance. The term coeliac derives from the Greek κοιλιακός (koiliakόs, "abdominal"), and was introduced in the 19th century in a translation of what is generally regarded as an ancient Greek description of the disease by Aretaeus ofCappadocia.[6][7]
Contents [hide] * 1 Signs and symptoms * 1.1 Gastrointestinal * 1.2 Malabsorption-related * 1.3 Miscellaneous * 1.4 Other grains * 2 Pathophysiology * 2.1 Genetics * 2.2 Prolamins * 2.3 Tissue transglutaminase * 2.4 Villous atrophy and malabsorption * 2.5 Risk modifiers * 3 Diagnosis * 3.1 Blood tests * 3.2 Endoscopy* 3.3 Pathology * 3.4 Other diagnostic tests * 4 Screening * 5 Treatment * 5.1 Diet * 5.2 Refractory disease * 5.3 Experimental treatments * 6 Epidemiology * 7 Social and religious issues * 7.1 Christian churches & the Eucharist * 7.2 Roman Catholic position * 7.3 Passover * 8 History * 9 References * 10 External links |-------------------------------------------------
[edit]Signs and symptoms
Severe coeliac disease leads to the characteristic symptoms of pale, loose and greasy stool (steatorrhoea), and weight loss or failure to gain weight (in young children). People with milder coeliac disease may have symptoms that are much more subtle and occur in other organs rather than the bowel itself. It is also possible to have coeliacdisease without any symptoms whatsoever.[5] Many adults with subtle disease only have fatigue or anaemia.[2]
[edit]Gastrointestinal
The diarrhoea that is characteristic of coeliac disease is (chronic) pale, voluminous and malodorous. Abdominal pain and cramping, bloatedness with abdominal distension (thought to be due to fermentative production of bowel gas) and mouth ulcers[8] may be...