Coeliac disease (celiac disease)
Autoimmune disorder triggered by gluten that damages the small intestine, causes malabsorption and varied symptoms; diagnosed by serology and biopsy and managed with a lifelong gluten‑free diet and medical follow‑up.
Coeliac disease is an immune‑mediated disorder in which ingestion of gluten — the storage proteins in wheat, rye and barley — provokes an abnormal immune response in susceptible people. The reaction damages the lining of the small intestine and reduces its ability to absorb nutrients. Presentation varies widely, from classic gastrointestinal symptoms to subtle or mainly extra‑intestinal problems.
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Pathophysiology
Genetic susceptibility interacts with environmental exposure to gluten so that immune cells recognise gluten‑derived peptides and trigger inflammation. This injures the intestinal mucosa, often causing flattening of the villi and loss of absorptive surface. The outcome is malabsorption of calories and micronutrients, and systemic immune activation; the condition may coexist with other autoimmune disorders.
Clinical features
Symptoms depend on age and duration. Young children commonly show chronic diarrhea, abdominal distension and faltering growth. Older children and adults may have abdominal pain, bloating, weight loss or iron‑deficiency anaemia. Non‑digestive manifestations include fatigue (from poor energy intake and anaemia), bone loss from poor calcium and vitamin D absorption, skin manifestations such as dermatitis herpetiformis, and neurologic or reproductive problems. Many affected people have subtle or atypical presentations.
Diagnosis
Diagnosis usually begins with serologic testing for characteristic antibodies, and is confirmed by examination of small‑bowel biopsy showing villous atrophy and crypt hyperplasia. Genetic testing can support assessment in ambiguous cases. Testing should be performed while the person continues to eat gluten to avoid false‑negative results. Evaluation also includes assessment of micronutrients including vitamin and mineral status.
Treatment and long‑term management
The only proven treatment is a strict, lifelong gluten‑free diet, supported by dietary education and regular clinical follow‑up. Practical measures include learning to read labels, avoiding cross‑contamination, and using certified gluten‑free products when needed. Some people tolerate uncontaminated oats. Nutritional supplementation, monitoring of bone density and periodic antibody testing are part of routine care.
Complications and prognosis
- With early diagnosis and adherence to a gluten‑free diet most people recover intestinal health and reduce long‑term risks.
- Untreated disease increases risk of persistent nutrient deficiencies, reduced bone density and, rarely, serious intestinal complications.
- Awareness and testing of at‑risk groups improves detection and outcomes; multidisciplinary care helps people adapt to lifelong dietary change.
For clinical guidance, patient support and information on related autoimmune conditions, consult specialist guidelines and reputable patient organisations. Professional dietary and medical follow‑up is recommended for diagnosis, treatment planning and ongoing monitoring.
Name origin
Celiac disease is the German equivalent of the Neo-Latin technical term coeliacia. The word derives from the Latin adjective coeliacus, with the basic meaning 'concerning the abdomen', but which is also translated in a further meaning as 'abdominal disease' (purely Latin ventriculosus). The Latin coeliacus in turn goes back to the Greek adjective κοιλιακός koiliakós, German 'suffering from digestion', which derives from κοιλία koilía, German 'abdominal cavity', 'belly', 'abdomen'.
Allergens
The allergens are the gliadins (the alcohol-soluble fraction of gluten) and glutenins. Depending on the type of cereal, these allergens have a different composition due to the evolution of cereals.
- Wheat, spelt (incl. green spelt), khorasan, durum: α-/β/ω-gliadin and glutenins, C-C allergen (baker's asthma), CBP2
- Barley: Hordenine amylase inhibitors IAM1 and CMb (both baker's asthma)
- Oats: Avenin A, E and F
- Rye: Secalinin
No allergens, because gluten-free, are the cereals
All pseudocereals are also gluten-free:
As different types of grain are often processed in the same company, cross-contamination cannot be ruled out. Gluten-free goods are indicated, for example, by the gf logo (crossed-out ear of corn), otherwise usually by the warning "may contain traces of gluten" (see section on EU Regulation).
Questions and answers
Q: What is Coeliac disease?
A: Coeliac disease is an autoimmune disorder in people when the indigestion of gluten leads to problems in the body.
Q: What happens if someone with coeliac disease eats something with gluten?
A: If someone with coeliac disease eats something with gluten (for example, wheat, rye, barley), cells inside the body attack the lining of the intestine.
Q: How does this affect digestion?
A: This means that they cannot digest food properly, making them unable to have enough energy, vitamins, or minerals.
Q: What are some common symptoms for children?
A: Children may be unable to grow taller or gain weight properly and often lose weight. They are also often tired.
Q: Is there a cure for Coeliac Disease?
A: No, there is currently no cure for Coeliac Disease but it can be managed by following a strict gluten-free diet.
Q: Are there any other treatments available?
A: Yes, medications such as probiotics and vitamin supplements may help manage symptoms associated with Coeliac Disease.
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AlegsaOnline.com Coeliac disease (celiac disease) Leandro Alegsa
URL: https://en.alegsaonline.com/art/21390