Celiac Disease

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Latest Edit: Iva Lloyd, ND 2014-05-21 (EDT)

Celiac disease is an immune mediated condition, triggered by the consumption of gluten-containing foods (wheat, rye, barley) in individuals who are genetically predisposed to intolerance.[1] When a person with Celiac disease consumes foods containing gluten, their immune system reacts by damaging the microvili (absorptive surfaces) in the gastrointestinal tract, primarily in the small intestine. This damage prevents adequate absorption of nutrients from the gut, resulting in malnourishment. Gliadin is the component in gluten that is responsible for the negative effects to the gastrointestinal system. In most populations, the prevalence is suspected to be 1% or higher, with 60-70% of those diagnosed being female. Detection has increased, however there remains a high rate of missed diagnoses.[2] Furthermore, research has recently shown that the prevalence of Celiac Disease has dramatically increased, not only due to increased detection.[3]

Celiac Disease
Celiac.jpg

Celiac Disease
Causes Food Reactions, Genetics, Stress
See Also Infections / Allergies / Sensitivities, Digestive Conditions
Books Books on Digestive and Liver Conditions
Articles Articles on Digestive Conditions
Article Gluten Sensitivity vs Celiac Disease, NDNR; 2012 April
Article Defining Gluten Sensitivity, International Celiac Disease Symposium Recap, NDNR [1], 2012 January





Naturopathic Assessment

Article Celiac Disease and Gluten-Associated Diseases , Alt Med; 2005;Vol10(3)


Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. Celiac disease is primarily a genetic predisposition to gluten intolerance, yet there are other factors that influence the onset of Celiac Disease, especially later in life. A detailed assessment is required to determine which factors are contributing to Celiac disease.

Lifestyle

  • It has been suggested that introducing gluten between 4-7 months of age and while the infant is still being breastfed may prevent some cases of celiac disease or may delay onset, however, longer term studies are currently undergoing.[4]
  • Gluten sensitivities can progress to Celiac disease over time.
  • Nutritional deficiencies and imbalances over time increase a person's risk of Celiac Disease

Social

Environmental

Genetics

  • The prevalence in first-degree relatives is 10% and 2 HLA haplotypes are associated with the disease.[5]
  • Celiac disease is strongly associated with HLA-DQ2 and/or HLA-DQ8 because both genotypes predispose for disease development[6]

Diagnostic Testing

Celiac disease can manifest in a number of different ways. It is often beneficial to test for Celiac disease in chronic conditions or when the root problem of a condition is difficult is determine. The following diagnostic testing is used to confirm Celiac disease.

Article Digestive and Nutritional Considerations in Celiac Disease: Could Supplementation Help? , Alt Med; 2009;Vol14(3)


Article Recognizing Gluten Sensitivity in Childen, NDNR, 2011 September
  • Blood tests that may be indicated include: endomysial antibodies, anti-tissue transglutaminase antibodies, anti-gliadin antibodies
  • Serological tests are typically used for screening, but diagnosis requires histological examination of the mucosa of the small intestine.[7]
  • Imaging Studies include Upper endoscopy, Duodenal biopsy

Related Symptoms and Conditions

Celiac Disease is associated with a wide range of conditions including:[5], [8], [2]

Characteristics

Long-term studies have demonstrated that the mortality of celiac disease is increased, if it is unrecognized and untreated.[9]

  • Celiac disease can develop at any point from infancy to adulthood

Common Symptoms

  • In some cases, these oral symptoms may be the only presenting symptoms.[10]

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies. Celiac disease is considered a chronic autoimmune disease. Naturopathic treatment options are chosen based on the other underlying conditions. The following treatment recommendations refer to the gluten intolerance only.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

  • Invest in gluten-free cookbooks or free gluten-free cooking blogs online
  • Always read labels since gluten is often hidden in foods, medications and nutritional supplements.

Lifestyle

Lifestyle recommendations include:

  • Removing all forms of gluten from the diet is essential.
  • Identifying and addressing any other food intolerances.
  • Even 1mg of gluten per day can prevent histologic recovery of the small intestine.[5]
  • Ensure you drink adequate water.

Naturopathic Therapies

Naturopathic Therapies for Celiac Disease include:[5]

References

  1. Kumar Vinay, Abbas Abul, Fausto Nelson, Mitchell Richard, editors. (2007) Robbins Basic Pathology 8th Edition. Saunders Elselvier, Philidelphia.
  2. 2.0 2.1 Shah S, Leffler D (2010 Sep) Celiac disease: an underappreciated issue in women’s health Womens Health (Lond Engl); Vol6(5):753-66 PMID: 20887172.
  3. Rubio-Tapia A, Murray JA (2010 Mar) Celiac disease Curr Opin Gastroenterol; Vol26(2):116-22 PMID: 20040864.
  4. Shamir R (2012 Jan) Can feeding practices during infancy change the risk for celiac disease? Isr Med Assoc J; Vol14(1):50-2 PMID: 22624444.
  5. 5.0 5.1 5.2 5.3 Prousky Johathan, Hoffer Abram. (2008) Principles and Practices of Naturopathic Clinical Nutrition. CCNM Press
  6. Tjon JM, van Bergen J, Koning F (2010 Oct) Celiac disease: how complicated can it get? Immunogenetics; Vol62(10):641-51 PMID: 20661732.
  7. Compilato D, Campisi G, Pastore L, Carroccio A (2010 Dec) The production of the oral mucosa of antiendomysial and anti-tissue-transglutaminase antibodies in patients with celiac disease: a review ScientificWorldJournal; Vol10:2385-94 PMID: 21170489.
  8. Ansaldi N et al. (Jul 2003) Autoimmune thyroid disease and celiac disease in children. J Pediatr Gastroenterol Nutr;37(1):63-66.
  9. Freeman HJ (2010 Apr) Risk factors in familial forms of celiac disease World J Gastroenterol; Vol16(15):1828-31 PMID: 20397258.
  10. Rashid M, Zarkadas M, Anca A, Limeback H (2011) Oral manifestations of celiac disease: a clinical guide for dentists J Can Dent Assoc;77:b39 PMID: 21507289.