Celiac Disease


Celiac disease is a chronic digestive disorder in which there is damage to the lining of the small intestine which leads to the malabsorption of minerals and nutrients. The destruction of the inner lining of the small intestine is caused by an immunological (allergic) reaction to Gluten (or the protein component in wheat, barley and related grains) and this stage is clinically termed as Gluten sensitivity.

Gluten is a wheat proteins present in barley, rye, wheat, and sometimes oats. A defect in the enzymes system which splits this protein fraction along with an atrophy of the jejunal mucosa may be the specific cause. Celiac disease usually develops within the first three years of life.


The child loses appetite and is pot-bellied. The stools are large, pale and offensive due to the presence of free fatty acids. Dwarfing and infantilism may gradually develop. 

Other symptoms like diarrhea, steatorrhea, weight loss, flatulence, iron deficiency anemia, abnormal bleeding, or weakened bones are common. However, many adults with Celiac disease may have either no symptoms or only vague abdominal discomfort such as bloating, abdominal distension, and excess gas.

 Children with Celiac disease may have stunted growth, and if left untreated, childhood Celiac disease can result in short stature as an adult.

The treatment of refractory Celiac disease is first to make sure that all the Gluten is eliminated from the diet.

Dietary Changes:

When Gluten derived from wheat or rye is completely excluded from the diet, there is a dramatic recovery. Thus, products like bread, biscuits, breakfast cereals, poories, paranthas, chapattis, macaroni and noodles must be entirely avoided. 

Anemia due to iron and folic acid deficiency may be present and therefore medicinal supplements of these vitamins have to be given. 

Gluten-free oats can provide a valuable source of fiber, vitamin B, iron, zinc and complex carbohydrates. Recent studies show that Gluten-sensitive individuals on a Gluten-free diet often get too much simple starch, too little fiber and vitamin B. 

To manage the disease and prevent complications, it\'s crucial that you avoid all foods that contain Gluten. Some of the foods which should be restricted are barley, flour, rye, semolina and wheat.

Children who have suffered for a short time respond to such a diet within a few weeks while patients who have been ill for years may require a three to six month dietetic treatment before they recover completely. A Gluten free diet should be consumed for at least five years after which small amounts of Gluten may be introduced. In adults with Celiac disease, the prognosis is not as good as it is in children.

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References disease/DS00319/DSECTION=treatments-and-drugs

Sharvi Rastogi

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