Condition

Celiac Disease

Celiac is an autoimmune disease triggered by a protein found in wheat known as gluten. Specifically, the reaction is due to the gliadin portion of the gluten protein.

Overview

Aetiology

Celiac is an autoimmune disease triggered by a protein found in wheat known as gluten. Specifically, the reaction is due to the gliadin portion of the gluten protein.

A significant immune reaction of the small intestine result in a flattening and gradual destruction of the microvilli. This eventually leads to malabsorption, and eventual nutrient deficiency conditions.

Causes are mainly genetic.

Presentation

Symptoms

Symptoms include chronic diarrhea, bloating, abdominal pain, and excessive wind, often with weight loss and fatigue. Because nutrients are poorly absorbed, the condition can lead to anemia, vitamin and mineral deficiencies, and in children, poor growth. Some people also experience non-digestive features such as an itchy blistering rash (dermatitis herpetiformis).

Assessment

Diagnostic Considerations

  • Blood Tests:

    • IgA and IgG, anti-endomysium antibodies, HLA-DQ2, HLA-DQ8
    • Fe, B12, Folate, tHcy
  • Biopsy of small intestine

Assessment

Differential Diagnosis

  • Non-Celiac Gluten Intolerance

Medical Treatment

  • Gluten free diet
  • Antiobiotics
  • Corticosteroids

Herbs for Celiac Disease

Herbs

  • Centella asiatica
  • hydrastis
  • Turmeric
  • Slippery elm
  • Calendula

Nutritional Medicine

  • Glutamine
  • Zn
  • A
  • C
  • E
  • Omega 3
  • Quercetin
  • Consider nutrient deficiencies

Diet

  • Gluten avoidance
  • Lower caffeine
  • Protein
  • High antioxidant intake

Supplementation

Supplementation (1)

Supplements, nutrients and compounds used for celiac disease.

Larazotide

Tight-junction regulator (zonulin-antagonist octapeptide)

An oral, gut-restricted zonulin-antagonist octapeptide trialled for celiac disease; its phase 3 trial was stopped for futility.

PeptideGutBarrierCeliac

References:

  1. Volta, U., Tovoli, F., Cicola, R., Parisi, C., Fabbri, A., Piscaglia, M., … & Caio, G. (2012). Serological tests in gluten sensitivity (nonceliac gluten intolerance). Journal of clinical gastroenterology, 46(8), 680-685.