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The condition is related in some way to dietary gluten and is either a hypersensitive reaction to a protein in certain cereal grains or a local toxic inflammatory reaction to gluten. A hereditary factor has been implicated because the disease occurs in familial clusters. Diagnosis is usually made in young to middle-aged adults, but the onset of symptoms often is traced to early childhood.
The symptoms of celiac disease are fairly typical of all malabsorption syndromes. Manifestations include large, foul-smelling, bulky, frothy, and pale-colored stools containing much fat. There are recurrent attacks of diarrhea, with accompanying stomach cramps, alternating with constipation. There is some edema and abdominal distention as in severe malnutrition, extreme weight loss, asthenia, deficiency of vitamins B, D, and K, and electrolyte depletion.
Diagnosis is based on intestinal biopsy and demonstrated pathological changes in the structure of the absorbing cells of the small intestine. In many cases, elimination of gluten from the diet produces a dramatic improvement in symptoms and restoration of normal function of the small intestine. Some patients experience remission within a few days, while others continue to have symptoms for months.
Treatment consists of placing the patient on a gluten-free diet that excludes all cereal grains except corn and rice. Since many prepared foods contain wheat, barley, rye, or oats to provide bulk, the patient must be cautioned to read all labels on packaged foods, even ice cream, salad dressings, condiments, and foods one would not expect to contain cereal products. (See also gluten.) Administration of corticosteroids may be necessary for some adults who do not respond to a gluten-free diet. There is evidence that celiac disease is associated with lymphoma and carcinoma of the small bowel; this is especially true of patients who have not been treated with a gluten-free diet.
Patient discussion about celiac
Q. Is celiac genetic? I have one son with celiac disease from my first marriage and me second wife is now pregnant,I was wondering what are the chances for this soon to be born daughter of mine to have celiac as well- if I maybe carry the genetic flaw and is there a way to find out?
Q. How do you diagnose celiac? My daughter is 3 years old and is constantly vomiting, has diarrhea and stomach aches. Could this be celiac?
Q. Is FTT a symptom of celiac? My 1.5 year old son has FTT (failure to thrive) and stomach aches. What could be causing it?