Atypical Celiac disease

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Definitions

It seems in today's society that more and more people are being diagnosed with celiac disease. Celiac "(SEE-lee-ak) disease is a digestive condition triggered by consumption of the protein gluten, which is primarily found in bread, pasta, cookies, pizza crust and many other foods containing wheat, barley or rye.". (http://www.mayoclinic.com/health/celiac-disease/DS00319/) Gluten according to dictionary.com is 1. the tough, viscid, nitrogenous substance remaining when the flour of wheat or other grain is washed to remove the starch. 2. Archaic . glue or a gluey substance. Celiac disease causes damage to the intestinal Villi in the small intestine. Intestinal Villi is multitudinous threadlike projections covering the surface of the mucous membrane lining the small intestine, serving as the sites of absorption of fluids and nutrients. (http://medical-dictionary.thefreedictionary.com/intestinal+villi)


Background/Timeline

Celiac disease has been described in literature dating back to the Second century A.D. by Aretaeus of Cappadocia. He talked about a condition called koiliakos (derived from koelia, Greek for abdomen) that caused abdominal pain and diarrhea, referring to patients with the malady as celiacs. However according to the timeline there isn't another mention again until 1888 by a physician named Samuel Gee. He suggested the affliction is associated with ones diet and suggested a banana and carb diet to relieve symptoms. If we fast forward to the 1940's a Dutch physician named Willem Karel Dicke’s recommended a wheat-free diet since he noticed a decline in patients symptoms during WWII while there was a shortage of bread. However the support for the diet quickly changed once the war was over and shortages were no longer a problem. Thankfully Dicke along with his colleagues in 1952 was able to to identify gluten as the problem after studying fecal matter samples, thus making a gluten free diet standard treatment. Four years later in 1956 a gastroenterologist named Margot Shiner developed a way to test for celiac disease by doing a biopsy on the villi in the small intestine which is still used today. Then in 1989 a immunologist named Lugvig Sollid narrowed down the two genetic risks for celiac on the histocompatibilty leukocyte antigen (HLA) molecule. Some 8 years later in 1997 a gastroenterologist named Detlef Schuppan in Berlin discovered that celiac patients have autoantibodies directed against tissue transglutaminase. Transglutaminase is a enzyme that gets released from the intestine's cells when gluten is passed into the mucosal layer. This finding led him to introduce a simple blood screening test for initial diagnosis. Moving into the beginning of the 21st century in 2000 a man named Alessio Fasano identified a molecule called zonulin. He believes the molecule increases intestinal permeability and vulnerability to celiac disease. Lastly since 2010 there has been clinical trials being run on nondietary therapies for celiac disease in hope to reduce intestinal permeability. (http://protomag.com/assets/celiac-disease-timeline-a-glutinous-history)



Symptoms

The symptoms one can experience form celiac disease can be very obvious like stomach crapping, bloating and diarrhea. However you dont have to present with those to be sick. Celiac disease can also cause Irritability or depression, Anemia, Stomach upset, Joint pain, Muscle cramps, Skin rash (Dermatitis herpetiformis), Mouth sores, Dental and bone disorders (such as osteoporosis),Tingling in the legs and feet (neuropathy) and malabsorption of nutrients. Dermatitis herpetiformis is an itchy, blistering skin disease that can be on torso, scalp and buttocks. Malabsorption can lead to fatigue, weight loss and stunted growth in children. (http://www.mayoclinic.com/health/celiac-disease/DS00319/DSECTION=symptoms) More symptoms include constipation, flatulence, heart burn, weight gain, sleep disorders, brain fog, migraines, restless leg syndrome, and gluten ataxia (loss of balance and coordination), endocrine diseases such as Sjorgren's syndrome and Addison disease, reproductive health problems and lastly celiac disease can raise your risk for cancers like lymphoma adenocarcinoma of the small intestine, carcinoid tumors and gastrointestinal stromal tumors. (http://celiacdisease.about.com/od/symptomsofceliacdisease/a/celiacsymptoms_2.htm) More nervous system disorders caused by celiac are epilepsy, myoclonus, internuclear ophthalmoplegia, and multifocal leukoencephlopathy. Unfortunately these disorders are considered hard disorders that may not respond to just a gluten free diet, making it necessary for other treatments that may include medications. Other nervous system disorders that are considered soft include hypotonia (flaccid muscles in babies), developmental delay, learning disorders and ADHD, headaches and cerebellar ataxia. One thing to remember is you may never experience any gastrointestinal symptoms, but still suffer from neurological ones due to celiac disease.(http://glutenfreeworks.com/blog/2008/03/13/neurological-disorders-gluten-celiac-disease/#.ULqvaVG0KSo)


Personal experience

My personal experience with this disease has only been for the last 6 months since my daughter got diagnosed. The Dr became increasingly concerned when my daughter was losing weight, quit growing and was severely constipated. She has dealt with constipation since birth but always had a good appetite and was growing until this year. At 8 1/2 she only weighed in a 43 lbs and was 47 inches tall putting her in the -10% when compared to other children her age. To put into perspective my daughter had the weight of an average 5 yr old and the height of an average 6 yr old . The Dr decided to send her to a dietician because of her growth problems. The dietician suggested an elimination diet to see if her appetite would increase so she could gain weight. The food we eliminated was gluten. Since the removal of gluten she has gained 7lbs and has grown 2 centimeters, plus her appetite has increased immensely. Before changing her diet she was never hungry and wanted to sleep a lot but now she eats 4 times a day and no longer needs naps. Also we realized that her spontaneous rashes went away and her hyperactivity somewhat improved. Size wise she is still small but at least it is an improvement from 6 months ago. I would have never thought it could have been celiac disease before seeing the dietician and I shutter to think what my daughters health would have deteriorated to before figuring it out. My advice to anyone experiencing unexplainable symptoms ask your Dr about it. All in takes is a simple blood test and if it comes back positive then you and Dr can go from there.

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