Celiac Disease an Imminent Peril

Celiac Disease - An Imminent Peril
Burger, pasta, noodles, waffles, pastries and oh, pizza! All these items never fail to make your mouth water. But what if you are intolerant to all these delicious items? Wouldn't that be a nightmare? These food items are made from a common source, wheat, which has a protein called as "Gluten" and if an individual comes out as gluten intolerant then that person suffers from Celiac Disease (Celiac Disease). Wheat is the staple food of India and also the main source of gluten. How can one avoid wheat, which is essential for day-to-day life

What is Celiac Disease and How Does it Evolve?
Celiac Disease is a lifelong autoimmune diseases disorder characterized by flattened villi (finger like projections in small intestine) and is induced in genetically susceptible people by the ingestion of proline-rich (amino acids) and glutamine-rich (amino acid proteins in wheat and its derivatives, barley, etc. It was originally thought to rarely occur in childhood, but now is recognized as a common condition that could be diagnosed at any age. Overall prevalence of Celiac Disease in India is 0.67% and 1.2% in northern parts of India which means that there are 60 to 80 lakh patients with Celiac Disease in India. Celiac Disease results from the interaction between gluten and immune system, genetic factors, and environmental as explained below

Gluten The entire protein component of wheat is gluten, and the fraction of gluten called as gliadin consists of all the toxic chemicals components. Undigested molecules of gliadin remain resistant to degradation by gastric, Amylase and intestinal brush border membrane proteases (enzyme that break down proteins) and hence remains in the intestinal lumen even after the gluten is digested.? During intestinal infections or when there is an increase in intestinal permeability, these undigested molecules gain entry into the intestine which results in inflammation and damages the intestinal villi.

Genetic Factors Celiac Disease is also influenced by genetic buildup of an individual. If the person has variant genes of HLA-DQA1 and HLA-DQB1,then the immune system reacts to gliadin proteins. This incongruous stimulation of immune system results in abnormal inflammatory response, which damages the body's organs and tissues and leads to the signs and symptoms of Celiac Disease.

Environmental Factors Factors like early introduction of gluten in relation to weaning in infants can develop the risk of Ced. The initial administration of gluten before four months increases the risk of Celiac Disease.

Infections Certain viral infections (Reoviridae family viruses) can trigger the immune system response and can lead to Celiac Disease.

Epigenetics Certain non-coding RNAs (ncRNA) can affect the immune system in a futile way and can contribute to Celiac Disease.

Microbiota Any shift in microbiota have been suggested to provoke Celiac Disease.

What is the most important complication of celiac disease?
If an individual possesses Celiac Disease, it is crucial not to eat any gluten. But if an individual is untreated or undiagnosed, and continues to eat gluten, then several complications can occur. It is a common myth that eating small quantity of gluten will not cause any harm, but even tiny amount of gluten intake can increase the risk of developing the complications outlined below
Malnutrition Celiac Disease decreases the effectiveness of the digestive system and can sometimes lead to critical lack of nutrients.
Malabsorption The failure of absorbing nutrients by intestine results in malabsorption
Bone loss Failure to absorb Calcium and vitamin D can contribute to poor bone density
Cancer Cancers are very rare but someone with Celiac Disease has a slightly increased risk of developing cancers such as small bowel cancer, Hodgkin lymphoma, small bowel lymphoma, etc.
Lactose intolerance If someone has Ced, then the individual is most likely to develop lactose intolerance, as the body lacks the enzyme to digest lactose found in dairy products
Celiac Disease in Pregnancy Celiac Disease can increase the risk of complications like giving birth to an underweight baby
Dental Defects
Irritability and Depression

How is celiac disease diagnosed?
Small intestinal Biopsy - Doctors take samples of tissue (a biopsy) from the small intestine to check
Serological Tests - Test antibodies called as an ti - Tissue Transglutaminase (anti-tTG). In practice, it has >85% sensitivity and >90% specificity
Genetic Tests - Test Human Leukocyte Antigens(HLA) to find possibilities of Celiac Disease

How do people cope with celiac disease?
Strictly adhering to a "gluten-free" diet is the mantra for healing and feeling good!
All food, drugs containing gluten must be eliminated because even small amounts can be harmful.

Further, organizations such as the Celiac India and Beyond Foundation, Celiaci Disease Foundation, Gluten Intolerance Group, The Celiac Support Association are support groups that can help you in managing it.

Thyrocare, provides TISSUE TRANSGLUTAMINASE - IgA (TTG) serological test, which is considered as the best screening method for Celiac Disease, at a very affordable price.