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CELIAC DISEASE

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CELIAC DISEASE Joanne Nugent M.S., R.D, L.D., CDE Celiac Disease An inflammatory disease of the small bowel initiated by gluten. Leading to malabsorption of nutrients ... – PowerPoint PPT presentation

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Title: CELIAC DISEASE


1
CELIAC DISEASE
  • Joanne Nugent M.S., R.D, L.D., CDE

2
Celiac Disease
  • An inflammatory disease of the small bowel
    initiated by gluten.
  • Leading to malabsorption of nutrients and effect
    all systems of the body

3
Celiac disease
  • Autoimmune diseaseintolerance to gluten
  • Gluten sensitive
  • Wheat allergy
  • 1 in 100 is the estimated prevalence of celiac
    disease.
  • Takes an average 11yr to get diagnosis
  • 35 exhibit chronic diarrhea
  • 2-3x more common in women
  • 97 of people with celiac have not been diagnosed

4
Pathophysiology
  • Villi are similar to shag carpet. Damage from
    gluten causes breakdown of villi.
  • When villi atrophy, the shag carpet is more
  • similar to a tile floor.
  • LEAKY GUT
  • This results in the inability to absorb certain
  • nutrients(iron,calcium,vit.- D,A,E,K,protein
  • and folic acid).

5
SYMPTOMS
  • GI symptoms
  • Chronic diarrhea/constipation
  • Abd pain/distention
  • Poor appetite/intake
  • Vomiting
  • Non GI symptoms
  • Dermatitis herpetiformis
  • Dental enamel hypoplasia
  • Osteopenia/osteoporosis
  • Iron deficient anemia
  • Delayed puberty
  • Infertility
  • Fatigue/irritability and failure to thrive

6
Complications
  • Lymphoma
  • Intestinal carcinoma
  • Osteoporosis
  • Refractory Celiac disease

7
Immune Disorders
  • Dermatitis herpetiformis
  • T1DM
  • Liver/Thyroid disease
  • Lupus
  • Addisons disease
  • Downs/Sjogrens syndromes
  • Rheumatoid Arthritis

8
Treatment
  • Lifelong diet that is gluten free
  • Total elimination of wheat, rye, and barley

9
Gluten???
  • Gluten is an elastic protein found in certain
    grains.
  • Proteins that cause problems for celiac
  • disease 1. Gliadin/wheat 2. Secalin/rye
  • 3. Hordein/barley.

10
Common Sources of Gluten
  • Pasta
  • Cereal
  • Bread, pizza crust, salad croutons
  • Crackers, pretzels
  • Cookies, cakes, pies, pastries
  • Beer
  • Cross contaminated oats/other food products

11
Foods that MAY contain Gluten
  • Candy
  • Soy sauce
  • Lunch/processed meats
  • Rice mixes
  • Seasoned chips
  • Canned soups/sauces
  • Imitation fish
  • Communion wafers
  • Matzo/matzo meal

12
Potential Sources
  • Chewing gum
  • Lipstich/balm
  • Personal care products shampoo, lotions
  • Medications prescription, OTC, herbal and
    vitamins and minerals

13
Flours containing gluten
  • Bulgur
  • Couscous
  • Kamut
  • Semolina
  • Spelt
  • Graham flour
  • Triticale
  • Wheat germ

14
Gluten-free flours
  • Rice flours
  • Almond flour
  • Amaranth
  • Arrowroot
  • Buckwheat
  • Corn flour-corn starch
  • Cornmeal
  • Gram flour(chick peas)
  • Potato starch flour
  • Quinoa
  • Soy (soya flour)
  • Tapioca starch
  • Teff grain
  • Potato flour
  • Sorghum flour

15
Gluten-Free Foods
  • Fruits
  • Vegetables
  • Milk, cream, most ice creams, cheese, cottage
    cheese, cream cheese
  • Potatoes, corn, rice, lentils, beans
  • Butter, margarine, oil, salad dressing (allowed
    ingredients)
  • Fresh meat, fish, poultry, eggs
  • Plain nuts, seeds, popcorn

16
MORE Gluten-free
  • Tea, coffee, soda
  • Distilled alcoholic beverages
  • Plain pickles, olives, relish, ketchup, tomato
    paste, mustard (with distilled vinegar,
    herbs/spices, black pepper
  • Honey, jam, jelly, corn/maple syrup, sugar

17
Labels
  • Food Allergen Labeling and Consumer Protection
    Act (FALCPA)
  • Food labels identify eight main food allergens
    (milk, eggs, panuts, tree nuts, fish, crustacean
    shellfish, soy and wheat
  • Gluten-free are wheat free, but wheat free
  • are not always gluten free

18
Compliance barriers
  • Cost
  • Availability
  • Taste/quality
  • Patients lack of symptoms
  • Difficulty with labeling of food/drugs
  • Poor education from healthcare providers

19
Resources
  • www.celiac.com
  • www.celiacsprue.com
  • www.niddk.nih.gov/health/digest/pubs/celiac/index.
    htm
  • www.glutenfree.com
  • Support group cinciceliac.com

20
Bottom Line
  • Celiac disease can be managed successfully with
    education, resources and support.

21
(No Transcript)
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