1. CELIAC DISEASE BY EMER BYRNE
Koiliakos (greek) = abdominal
Endemic Spure (chronic form of mal-absorption syndrome)
Gluten Enteropathy
Non-tropical Spure

2. CHARACTERISTICS Autoimmune Disease (delayed allergy)
(Triggered; surgery, pregnancy, viral infection)
Small Bowl
Reaction to Gliadin [gly-eh-din]
(Gluten protein found in Wheat)
Children (9-24mts) – Bowl symptoms
Adults – Malabsorption related problems

3. PATHOLOGY Exposure to Gliadin Enzyme Tissue Transglutaminase modifies
Cross-reaction with bowl tissue
Inflammatory reaction
Flattening in villi
Interfering in absorption of nutrients

4. SYMPTOMS Fatigue Chronic Diarrhea Failure to thrive (children)
Weight loss (adults)
Malabsorption related symptoms
- Anemia (fe def, and megaloblastic)
- Vit. K def
- Osteopenia (Ca and Vit D def)

5. COMPLICATIONS Lymphoma Adenocarcinoma Osteoporosis
Ulcerative jejunitis and stricturing
(ulcers and narrowing)

6. FOODS TO AVOID All foods containing wheat, barely, rye and oats
- bread, pasta, cereals and beer
Artificial flavourings and colourings
Crisps and sweets
Vitamins, Medicines
Specific spirits
Stamp and Envelope adhesives

7. DIAGNOSIS Blood tests - IgA - Anti EMA ( Endomysium)
- Anti TTg ( Tissue Transglutaminase)
Endoscopy ( Gold standard)

8. ENDOSCOPY Upper GI Endoscopy - EGD ( esophagogastroduodenoscopy )
Visual examination of upper GI
Lighted, flexible fibro-optic or video scope
15-30 mins
Outpatient procedure
No pain

10. Pathologic Duodenum Normal Duodenum

11. TREATMENT Lifelong gluten-free diet - Potato - Rice
- Unprocessed; meat, fish, fruit and vegetables
- Wine
- Rum and Tequila

12. GLUTEN-FREE FOODS
Most foods are now available in gluten-free

13. PROGNOSIS
Intestinal damage begins to heal within weeks

14. WHY NOW?? Glutens; very cheap and tasty
- used more and more in unprocessed foods
- larger profits for food manufactories
Water soluble gliadin = Problem
- fine grinding, baking, fermenting, chemical treatment and synthesis

15. EPIDEMIOLOGY 1% of Indo-Europeans; - Celtics - Balts
- Germanic Peoples
- Latins
- Slavs
Prevalence
- 1/300 Ireland
- 1/133 America (3 million)

16. THANK YOU FOR YOUR ATTENTION

17. REFERENCES http://www.celiac.org/ http://www.celiac.nih.gov/