The Role of the Clinical Laboratory in Nutritional Assessment
Aruna Bakhru in Nutrition and Integrative Medicine, 2018
Celiac disease is an autoimmune disorder in which people cannot tolerate gluten because it damages the inner lining of the small intestine and prevents the absorption of many nutrients. In response to gluten found in wheat, rye, and barley, the immune system responds by damaging or destroying villi lining of the small intestine. Consequences include malnutrition and deficiencies of fat-soluble vitamins, iron, zinc, and other micronutrients, and potentially vitamin B12 and folic acid. Although many patients experience gastrointestinal symptoms, some patients have a specific skin disease, dermatitis herpetiformis. Many patients have no symptoms but suffer from malabsorption. Long-term consequences, when untreated, include growth retardation in children, osteoporosis, infertility and miscarriage, and neurological conditions such as migraines and epilepsy.
Chronic GI Disorders
Andrea Kohn Maikovich-Fong in Handbook of Psychosocial Interventions for Chronic Pain, 2019
Because the symptoms of IBS are fairly nonspecific and are not associated with abnormal radiologic or endoscopic abnormalities or with any reliable biomarkers, differential diagnosis can be tricky and is typically made on clinical grounds (Ford, Moayyedi et al., 2014). Indeed, current evidence suggests that performing multiple diagnostic tests (especially invasive testing such as colonoscopy) typically is not warranted (Cash, Schoenfeld & Chey, 2002). Nevertheless, most IBS patients will visit multiple doctors and have some testing done before the diagnosis is confirmed (Lacy et al., 2016). Some rule-outs are important to make, especially in IBS-D cases, and some “alarm” symptoms suggest that whatever is going on is not IBS (Lacy, 2016b). Alarm symptoms include fever, pain that wakes people out of a sound sleep, high white count, anemia, and blood in the stool. Two of the most important conditions to rule out are celiac disease and inflammatory bowel disease. A basic work-up for IBS should include bloodwork to check for elevated white count (an indication of inflammation) and for nutritional deficiencies such as anemia and B12 insufficiency, both of which suggest a diagnosis other than IBS since they indicate that the gut is actually failing to absorb nutrients appropriately. Testing also should include bloodwork to rule out celiac specific antibodies. Celiac disease is an autoimmune disorder in which the body becomes sensitized to gluten and the immune system attacks the tissues of the gut when gluten is present.
High Consumption of Whole Grains
John J.B. Anderson, Marilyn C. Sparling in The Mediterranean Way of Eating, 2014
Gluten is a protein found in certain grains and grain products, including wheat, barley, and rye. Individuals of any age can become sensitive to gluten and develop celiac disease (also called celiac sprue and gluten-sensitive enteropathy). In this condition, the body’s immune system attacks the gluten in foods and damages the small intestine. The ongoing damage results in chronic inflammation, and the body loses its ability to absorb nutrients efficiently from food. Symptoms of celiac disease vary widely, from mild to severe, and can include abdominal pain, bloating, weight loss, and diarrhea. Following a lifelong gluten-free diet is the only treatment. Fortunately, the number and variety of gluten-free foods on the market has been increasing dramatically. However, this does not mean all gluten-free foods are healthy. It remains important to consider the whole food and its other ingredients to see how it fits with a healthy overall dietary plan. Some gluten-free foods are made with refined grains and not enriched or fortified with important vitamins and minerals. These foods may also be high in fat and sugar and low in fiber. For individuals who do not have celiac disease, there is typically little benefit to eating a gluten-free diet.
Addressing the social needs of individuals with food allergy and celiac disease during COVID-19: A new practice model for sustained social care
Published in Social Work in Health Care, 2021
Lucy A. Bilaver, Rajeshree Das, Erin Martinez, Emily Brown, Ruchi S. Gupta, Marissa Love
Both health conditions affect an increasing number of patients nationwide. Food allergy (FA) is a potentially life-threatening chronic condition (Bock, 2001; Jones et al., 2017; Rudders et al., 2010), that affects approximately 32 million U.S. children and adults including 7.6% of U.S. children and 10.8% of U.S. adults (Gupta, Warren, Smith, Blumenstock, et al., 2019, Gupta, Warren, et al., 2019). Children living with food allergy often experience impaired health-related quality of life, have frequent school absences, and are at an increased risk of emergency department (ED) utilization and hospitalizations for care (Motosue et al., 2017; Warren et al., 2016). Forty percent of children and 51% of adults with food allergy report experiencing a severe life-threatening reaction in their lifetime, and one in five children report at least one food allergy-related ED visit per year. Celiac disease is a chronic autoimmune disorder which occurs in genetically predisposed individuals and is characterized by small intestinal inflammation due to gluten (Green & Jabri, 2003). The prevalence of celiac disease in the United States was found to be around 1% (Rubio-Tapia et al., 2012), but studies have shown an increasing prevalence of the disorder (Ludvigsson et al., 2013).
A review on the relationship between gluten and schizophrenia: Is gluten the cause?
Published in Nutritional Neuroscience, 2018
Can Ergün, Murat Urhan, Ahmet Ayer
Celiac disease is a lifelong auto-immune disease diagnosed in patients who possess a genetic predisposition which shows susceptibility to gluten and disruptions in the small intestine. Gluten is found in wheat, barley, oat, and rye. Gluten is characterized as a protein, which stores prolamin and glutelin. The majority of proteins in foods that are responsible for immunological reactions, which lead to the onset of celiac disease, are prolamins. Prolamins are found in varying forms in several grains, such as gliadin in wheat, hordein in barley, secalin in rye, and zein in corn. Gliadin is an essential monomeric protein with a molecular weight ranging between 28 000 and 55 000. It consists of four types: α-, β-, Ɣ-, and ω-. They have high amounts of glutamine and are resistant to gastrointestinal proteolytic enzymes. The most toxic form of gliadin, α-gliadin 33mer, is one of the digestion-resistant gluten peptides that show high reactivity for isolated celiac T cells. It is the main immune-dominant toxic peptide. Other significant types that show toxic effects are α-gliadin p31–43.8–11
A case of celiac disease presenting with celiac crisis: rare and life threatening presentation
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Rakshya Poudyal, Saroj Lohani, William B. Kimmel
Celiac disease is a multiple organ autoimmune disease precipitated by gluten proteins that affects small intestine in genetically predisposed children and adults [1]. The common manifestations of celiac disease are bulky, foul smelling diarrhea, abdominal distension and consequences of malabsorption such as failure to thrive, weight loss, anemia and osteopenia [2]. Celiac crisis is a life threatening manifestation of celiac disease especially in children and rarely in adults. Celiac crisis usually presents with severe diarrhea, low protein and severe metabolic and electrolyte derangements that require hospitalization and treatment [3,4]. Celiac crisis is associated with high morbidity and mortality [5]. It is important to have high index of suspicion of celiac crisis especially in people with undiagnosed celiac disease since it can be the initial presentation of celiac disease as in our case report.