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Understanding Celiac Disease
What is Celiac Disease?
It is an intestinal disease with wide spectrum of clinical manifestations, ranging from asymptomatic to severe malabsorption, caused by a complex interplay of intrinsic and extrinsic factors. The intrinsic factor is genetics imprinting the susceptibility of an individual to be gluten-sensitive in intestine. The extrinsic factor is the environmental factor, i.e., the presence of gluten.
In genetically susceptible individuals, their intestines are characterized by damaged mucosa and hence many secondary problems associated. Prolonged untreated celiac disease, even if clinically silent, predisposes for other autoimmune diseases.
How Celiac Disease Affects Our Body?
In Celiac Disease, damages on the mucous layer of the small intestine by own immune system are often observed. The damages are most marked in the duodenum and upper jejunum, but in some cases, the entire small intestine may be involved. These damages lead to the classic symptoms of Celiac Disease, such as chronic diarrhea, anorexia and abdominal distention.
Systemically speaking, Celiac Disease has its impact on our body usually secondary to malabsorption due to destructions on the mucous layer of the small intestine, though there are a number of atypical symptoms independent of malabsorption. The affected individuals may suffer from failure to thrive, anorexia, muscle wasting, noticeable thin and watery stool with dehydration and electrolyte imbalance. Moreover, a number of other medical conditions are significantly association with CD.
Who will be affected?
Celiac disease symptoms can develop at any age when foods in your diet are containing gluten. Not only children, individuals aged between 30 and 60 years are determined as a group with high occurrence of having celiac disease.
High risk group: First-degree relatives of a person (parent, child, sibling) with celiac disease have around 10% chance of having this condition.
Adults: Genetically susceptible adults who are consuming gluten, acute symptoms are sometimes triggered by stress, infections, surgery or pregnancy.
Children: Recurrent gastrointestinal infections can be a factor in the expression of this disease.
Possible Symptoms Associated with Celiac Disease
| Typical Symptoms |
| Chronic diarrhea |
| Failure to thrive |
| Abdominal distention |
Typical symptoms are those symptoms commonly seen in the Celiac Disease patients. With these recurrent symptoms alone or in combination, one should consider taking the Celiac Screening.
Atypical Symptoms
(Secondary to malabsorption) |
| Sideropenic anemia |
| Short stature |
| Osteopenia |
| Recurrent abortions |
| Hepatic steatosis |
| Recurrent abdominal pain |
| Gaseousness |
In Accordance to a research paper published by American Gastroenterological Association in 2001, the above are the symptoms that usually appear secondary to malabsorption of nutrients due to small intestine destructions. They are atypical because they only appear in Celiac Disease patients occasionally. Even if they do show up, they are usually considered to be medical conditions occurring alone and may often be ignored their possible correlations with Celiac Disease.
From the same study, the following atypical symptoms are not the results of nutrient malabsorption, but may still be coupled with Celiac Disease.
Atypical Symptoms
(Independent of maladsorption) |
| Dermatitis herpetiformis |
| Dental enamel hypoplasia |
| Ataxia |
| Alopecia |
| Primary biliary cirrhosis |
| Isolated hypertransaminasemia |
| Recurrent aphthous stomatitis |
| Myasthenia gravis |
| Recurrent pericarditis |
| Psoriasis |
| Polyneuropathy |
| Epilepsy (with or without intracranial calcifications) |
| Vasculitis |
| Dilatative cardiomyopathy |
| Hypo/Hyperthyroidism |
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