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CELIAC DISEASE

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CELIAC DISEASE - PowerPoint PPT Presentation


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CELIAC DISEASE. WHAT WE WILL COVER. Development of the disease Types of Celiac disease Associated Conditions Symptoms Why is it so hard to diagnose Gluten-free diet Resources for you and your patients. Celiac Isn’t…. a food allergy. Celiac Is…. Curable.

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what we will cover
WHAT WE WILL COVER
  • Development of the disease
  • Types of Celiac disease
  • Associated Conditions
  • Symptoms
  • Why is it so hard to diagnose
  • Gluten-free diet
  • Resources for you and your patients
celiac isn t
Celiac Isn’t…

a food allergy

Celiac Is….

Curable

An autoimmune disorder that is characterized

by consuming a protein called gluten

Treatable

fast facts
FAST FACTS
  • 1. One in 133 Americans have celiac disease.
  • 2. Three million Americans across all races, ages and genders suffer from celiac disease.
fast facts1
FAST FACTS

3. 17% of celiac patients have an immediate family

member who also has celiac.

6. $5,000-$12,000 is the average cost of misdiagnosis per person

per year, not including lost work time.

details about celiac disease
Details about Celiac Disease

Sometimes called:

  • Celiac sprue
  • Non-tropical sprue
  • Gluten sensitivity
  • Gluten enteropathy
celiac disease
Celiac Disease
  • Autoimmune disorder
  • Often triggered by a stressful event
  • Damages the villi of the small intestine
  • Interferes with the absorption of nutrients
risk factors
Risk Factors
  • It is a genetic disorder
  • 17% of celiac patients have an immediate family member with celiac disease
  • Was thought to be a disease of infants but now often presents between the ages of 10 and 40
how do we test for celiac
How do we test for Celiac?
  • Serology
    • IgA anti tissue transglutaminase antibody (IgA tTg)
    • IgA endomysial antibody (IgA EMA)
    • IgA antigliadin antibody (IgA AGA)
    • IgG antigliadin antibody (IgG AGA)
application of serology tests
Application of Serology Tests
  • Individuals with low pretest probability
  • Individuals with moderate or high probability
  • Monitoring adherence and response to gluten-free diet
other serology tests
Other Serology Tests
  • Genetic testing
    • HLA DQ2
    • DQ8
    • Those without these genetic markers are very unlikely to have celiac disease
other serology tests1
Other Serology Tests
  • Testing for malabsorption problems
    • Iron Deficiency Anemia
    • Folic Acid Deficiency
    • Vitamin D Deficiency
problems with serology testing
Problems with Serology testing
  • Not 100% accurate
  • Can be falsely negative if patient has started a gluten-free diet
pathology
Pathology
  • Small Bowel Biopsy
    • Multiple biopsies from second and third portion of duodenum
problems with pathology
Problems with Pathology
  • May not be accurate if patient has started a gluten-free diet
  • Other causes for Villious atrophy
types of celiac disease
Types of Celiac Disease
  • Classical Form
    • Villous Atrophy
    • Symptoms of malabsorption
      • Steatorrhea
      • Weight loss
      • Signs of vitamin and nutrient deficiencies
    • Resolution of mucosal lesions and symptoms when on gluten-free diet
types of celiac disease1
Types of Celiac Disease
  • Classic Form
  • Latent Form
    • Positive serology but negative pathology
    • No or minor symptoms while on normal diet
    • Normal mucosa at one time but Celiac developed later
types of celiac disease2
Types of Celiac Disease
  • Classic Form
  • Latent Form
    • Positive serology but negative pathology
    • No or minor symptoms while on normal diet
    • Normal mucosa at one time but Celiac developed later
  • Potential Celiac Disease
    • Negative pathology but positive serology including genetic predisposition and 1st degree relative
types of celiac disease3
Types of Celiac Disease
  • Classic Form
  • Latent Form
    • Positive serology but negative pathology
    • No or minor symptoms while on normal diet
    • Normal mucosa at one time but Celiac developed later
  • Potential Celiac Disease
    • Negative pathology but positive serology including genetic predisposition and 1st degree relative
  • Subclinical Disease
    • Very mild form and goes widely undetected
      • Malignancy, nutritional deficiencies, low birth-weight infants, occurrence of autoimmune disorders
associated conditions
Associated Conditions
  • Celiac disease can lead to a number of other disorders including infertility, reduced bone density, neurological disorders, some cancers and other autoimmune diseases.
  • Frequently associated with Dermatitis Herpetiformis, Down Syndrome, Type 1 Diabetes, Thyroid Disease, Liver Disease, and Atopic Dermatitis
slide27

Bloating

Gas

Diarrhea

Abdominal Pain

Constipation

Weight Loss

slide29

Headaches

Irritability

Depression

Tingling/Numbness

slide30

Infertility

Growth

Thin Bones

Joint Pain

Dental

slide31

Pale Mouth Sores

Fatigue

Itchy Skin Rash

why is this hard to diagnose1
Why is this hard to Diagnose?
  • 97% of celiacs are undiagnosed or misdiagnosed with other conditions.
  • 10 years is the average time a person waits to be correctly diagnosed.
  • $5,000-$12,000 is the average cost of misdiagnosis per person per year, not including lost work time.
increase awareness
Increase Awareness
  • 500,000 new celiac diagnoses are expected to occur in the next 5 years thanks to efforts to raise public awareness of celiac disease.
treatment
Treatment
  • There are NO pharmaceutical cures for celiac disease.
  • A 100% gluten-free diet is the only existing treatment for celiac disease.
what is gluten
What is Gluten?
  • The group of proteins found in wheat, rye, and barley
  • It’s found in obvious foods like bread, pasta, and cereals
  • Also found in many “hidden” foods
breads grains cereals
Breads, Grains, Cereals
  • Rice
  • Corn
  • Potato
  • Tapioca
  • Soy
  • Millet
  • Beans
vegetables and fruits
Vegetables and Fruits
  • Naturally gluten free
  • May add pure spices but be careful of spice blends as they often use gluten as a filler
milk and dairy
Milk and Dairy
  • May need to avoid Lactose until intestines heal
  • Gluten-free, Dairy-free alternatives
    • Rice, soy, hemp, or nut (almond, hazelnut)
  • Gluten-free lactase enzyme supplement
meats and other proteins
Meats and other Proteins
  • Beef, Chicken, Pork, and Fish are naturally gluten-free unless they have been seasoned or basted (turkey, deli meat, etc.)
fats oils and sweets
Fats, Oils, and Sweets
  • Olive and Canola oils
  • Nuts and Pure nut butters
  • Avoid candies not marked gluten free
gluten free products
Gluten-free Products
  • The gluten-free marketplace is growing by 28% each year
  • Find Gluten-free products in specialty health food stores
  • Now available in many grocery stores including Meijer, Kroger, Walmart, etc
  • Also available on-line
slide48

C

  • E
  • L
  • I
  • A
  • C

onsultation with skilled dietitian

ducation about the disease

ifelong adherence to gluten-free diet

dentify & treat nutritional deficiencies

ccess to an advocacy group

ontinuous long-term follow-up

resources
Resources
  • Physician/Endoscopy office
  • Web
    • www.celiac.org
    • www.gluten.net
    • www.csaceliacs.org
    • www.americanceliac.org
    • www.celiacawareness.org
    • http://celiacdisease.about.com/forum
resources1
Resources
  • Friends
  • Library…Cookbooks, etc
personal passion
Personal Passion
  • I first heard gluten enteropathy when I was about 9 years old
  • Limited products
  • Associated conditions
  • I now live with Celiac Disease
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