The Diagnostic and Therapeutic Options of Celiac Disease - Essay Example

of the of the Concerned 2 November 2008 Celiac Disease Celiacdisease is the name given to an autoimmune disorder that has a debilitating impact on the digestive activities of the small intestine (The University of Chicago Celiac Disease Center 1). A person suffering from celiac disease has a specific intolerance for gluten, a protein found in most of the common cereals like wheat, barley and rye. The consumption of gluten by such patients results in a strong immune system response that hampers the absorption of vital nutrients. Celiac disease if left untreated could lead to further complications like autoimmune disorders, neurological problems, infertility and in some cases even cancer also (The University of Chicago Celiac Disease Center 1). "The incidence of auto immune disorders in the general US population is 3.5 % (The University of Chicago Celiac Disease Center 2)." As per some well informed estimates, nearly 3 million Americans suffer from celiac disease. An average healthy person in the US has roughly 1 in 133 chances of being affected by this disorder. Persons having a first-degree or second-degree relative suffering from celiac disease do often have a more then average probability of being affected by this disease. Most of the patients suffering from celiac disease develop related complications owing to a delayed diagnosis. Thus an early diagnosis of celiac disease is very important as this may significantly reduce the risk of developing further complications (The University of Chicago Celiac Disease Center 2). Though the etiology of celiac disease has not conclusively been established till date, environmental, immunologic and genetic factors have been found to be significant contributors to the disease. The most prominent environmental factor is the association of this disease with gluten. Not only does gluten restriction plays a central role in the treatment of this disease, but the insertion of gluten in the normal appearing rectum and distal ileum of the affected patients results in discernable morphologic changes (Kasper, et al. 1771). An immunologic component to this disease is strongly suspected because of the presence of "serum antibodies- IgA antigliadin, IgA antiendomysial and IgA anti-tissue transglutaminase (tTg) (Kasper et al. 1771)" in the affected patients. Also the patients treated with prednisolone have been found to respond favorably. A genetic factor is certainly associated with this order, since the Caucasians have been found to have a higher prevalence of celiac disease as compared to blacks and Asians (Kasper et al. 1771). Though the symptoms of celiac disease may vary from patient to patient, the common symptoms may involve: bloating, abdominal pain, diarrhea, constipation, discolored teeth or loss of enamel, joint pain, significant unexplained weight loss, delayed growth, fractures or thin bones, bulky or loose stools, fatigue, tingling or numbness in the limbs, canker sores, irritability or behavior changes, poor weight gain and missed menstrual periods (National Foundation for Celiac Awareness). Illnesses like: Anemia, depression, Type I diabetes, Sjogren's syndrome, dermatitis herpetiformis, infertility, IBS, peripheral neuropathy, Turner Syndrome, osteoporosis, thyroid disease, juvenile idiopathic arthritis, intestinal cancer, Down syndrome, Williams syndrome, may also be linked to celiac disease (National Foundation for Celiac Awareness). The most credible way of diagnosing celiac sprue is a small intestine biopsy. A biopsy should unexceptionally be performed on the patients exhibiting distinct symptoms of celiac disease, like nutrient deficiency and malabsorption (Kasper et al. 1772). Many a times the patients suffering from celiac disease fail to exhibit any distinct or conspicuous symptoms of this malady. In the recent years, the incidence of asymptomatic cases of celiac disease has been on the rise (Craig et al 1). Thus it is imperative for a diagnostician to go for a biopsy on the appearance of suggestive laboratory findings and symptoms (Kasper et al 1772). The instances of celiac sprue reveal distinct histopathalogic changes in the small intestine mucosa that are effectively reverted following the intake of gluten free diet (Kasper et al. 1772). Though the specialists tend to vary a lot as to the number of biopsies required to diagnose celiac sprue, research has established that a minimum of four biopsies must be performed to arrive at any authentic decision (Johnson 1). Patients diagnosed with celiac sprue must take utmost precaution to avoid gluten in their diet. Consumption of cereals like wheat or rye must unexceptionally be replaced by safer options like rice. In nearly 90 percent of the patients diagnosed with celiac disease, the gluten restriction has been found to be accompanied by an appreciable recovery. Studies tend to vary a lot as to the threshold amount of gluten that the patients diagnosed with celiac disease can tolerate. The results have been found to vary from one patient to other. While some patients were found to tolerate a conspicuously high intake of 34 to 36 mg of gluten per day, there were other patients who exhibited mucosal abnormalities on the consumption of only 10 mg of gluten per day (Akobeng & Thomas 1). To be on the safe side, a consumption of 10 mg of gluten per day is considered to be allowable by a majority of the specialists. The current therapeutic approach towards celiac disease insists on a strict and stringent adherence to a gluten free diet for life. However, an effective compliance with this line of treatment has been found to be very difficult. Not only gluten is a commonly found ingredient in the regular human diet, but also, authentic gluten free dietary alternative are not readily available in the market and are usually quiet expensive. Thus, dietary compliance has been found to be peculiarly imperfect in a majority of the patients suffering from celiac disease. So the greatest challenge before the researchers in the current scenario is to develop pragmatic and effective therapeutic options. Celiac disease has become a cause for concern for the medical community in North America and the situation has become more urgent, considering a worrisome rise in the number of patients diagnosed with this disease. However, the recent fundamental studies have turned out to be promising and full of hope. In the times to come, the diagnostic and therapeutic options are expected to get more effective and refined. Total Words: 1,022 Works Cited Akobeng, A.K. & A.G. Thomas. "Systematic Review: Tolerable Amount of Gluten for People with Celiac Disease". Alimentary Pharmacology & Therapeutics. 28 August 2008. 2 November 2008 "Celiac Disease Facts and Figures". The University of Chicago Celiac Disease Center. August 2005. 2 November 2008 Craig, Darren, et al. "Advances in Celiac Disease". Current Opinion in Gastroenterology. 21 February 2008. 2 November 2008 "Do I have Celiac. National Foundation for Celiac Awareness. 3 September 2008. 2 November 2008 Johnson, David A. "Number of Endoscopic Biopsy Specimens Needed to Confirm a Diagnosis of Celiac Disease". Medscape Gastroenterology. 8 June 2008. 2 November 2008 Kasper, Dennis L., et al. Harrison's Principles of Internal Medicine (Volume II). Chicago: McGraw-Hill Medical Publishing Division, 2004. Read More