Celiac disease Symptoms (सीलिएक रोग के लक्षण)
The classic symptoms of untreated coeliac disease include:
- Pale, loose, and greasy stool (steatorrhoea)
- Weight loss or failure to gain weight
Other common symptoms may be subtle or primarily occur in organs other than the bowel itself. It is also possible to have celiac disease without any of the classic symptoms at all.
Gastrointestinal (जठरांत्र संबंधी)
Diarrhea that is characteristic of coeliac disease is chronic, pale, of large volume, and abnormally bad smelling. Abdominal pain and cramping, bloatedness with abdominal distension (thought to be due to fermentative production of bowel gas), and mouth ulcers may be present.
Screening for celiac disease is recommended by the NICE, the British Society of Gastroenterology and the American College of Gastroenterology, but is of unclear benefit in North America.
The celiac disease leads to an increased risk of both adenocarcinoma and lymphoma of the small bowel. This risk is also higher in first-degree relatives such as siblings, parents, and children. Whether or not a gluten-free diet brings this risk back to baseline is not clear.
The changes in the bowel make it less able to absorb nutrients, minerals, and fat-soluble vitamins A, D, E, and K:
- The inability to absorb carbohydrates and fats may cause weight loss and fatigue or lack of energy.
- Anemia may develop in several ways: iron malabsorption may cause iron deficiency anemia, and folic acid and vitamin B12 malabsorption may give rise to megaloblastic anemia.
- Calcium and vitamin D malabsorption may cause osteopenia or osteoporosis.
- Selenium malabsorption in celiac disease, combined with low selenium content in many gluten-free foods, confers a risk of selenium deficiency.
- Copper and zinc deficiencies have also been associated with celiac disease.
- A small proportion has abnormal coagulation due to vitamin K deficiency and is slightly at risk for abnormal bleeding.
Celiac disease Cause (सीलिएक रोग का कारण)
Celiac disease is caused by a reaction to gliadins and glutenins found in wheat, and similar proteins found in the crops of the tribe Triticeae and the tribe Aveneae (oats). Wheat subspecies and wheat hybrids also induce symptoms of celiac disease.
A small number of people with celiac react to oats. Oats toxicity in celiac people depends on the oat cultivar consumed because of prolamin genes, protein amino acid sequences, and the immunoreactivities of toxic prolamins, which are different among oat varieties.
Other Grains (अन्य अनाज)
Cereals such as corn, millet, sorghum, teff, rice, and wild rice are safe for people with celiac to consume, as well as non-cereals such as amaranth, quinoa, and buckwheat.
Non-cereal carbohydrate-rich foods such as potatoes and bananas do not contain gluten and do not trigger symptoms.
Risk modifiers (जोखिम संशोधक)
There are various theories as to what determines whether a genetically susceptible individual will go on to develop celiac disease. Major theories include:
- Emotional stress
The eating of gluten early in a baby’s life does not appear to increase the risk of a Celiac disease but later introduction after 6 months may increase it.
Celiac disease Diagnosis (सीलिएक रोग का निदान)
There continues to be a lack of awareness among physicians about the variability of presentations of celiac disease and the diagnostic criteria, such that most cases are diagnosed with great delay. It can take up to 12 years to receive a diagnosis from the onset of symptoms and the majority of those affected in most countries never receive it.
Celiac disease Blood test (सीलिएक रोग रक्त परीक्षण)
Serological blood tests are the first-line investigation required to make a diagnosis of celiac disease. Its sensitivity correlates with the degree of histological lesions.
Other diagnostic tests (अन्य नैदानिक परीक्षण)
At the time of diagnosis, further investigations may be performed to identify complications, such as iron deficiency (by full blood count and iron studies), folic acid and vitamin B12 deficiency and hypocalcemia (low calcium levels, often due to decreased vitamin D levels). Thyroid function tests may be requested during blood tests to identify hypothyroidism, which is more common in people with celiac disease.
Osteopenia and osteoporosis, mildly and severely reduced bone mineral density, are often present in people with celiac disease, and investigations to measure bone density may be performed at diagnosis, such as dual-energy X-ray absorptiometry (DXA) scanning, to identify the risk of fracture and need for bone protection medication.
Gluten withdrawal (लस वापसी)
Although blood antibody tests, biopsies, and genetic tests usually provide a clear diagnosis, occasionally the response to gluten withdrawal on a gluten-free diet is needed to support the diagnosis. Currently, gluten challenge is no longer required to confirm the diagnosis in patients with intestinal lesions compatible with celiac disease and a positive response to a gluten-free diet.
Celiac disease Screening (सीलिएक रोग की जांच)
In the United Kingdom, the National Institute for Health and Clinical Excellence (NICE) recommend testing for celiac disease in first-degree relatives of those with the disease already confirmed, in people with:
- Persistent fatigue
- Abdominal or gastrointestinal symptoms
- Faltering growth
- Unexplained weight loss or iron
- Vitamin B12 or folate deficiency
- Severe mouth ulcers
- Diagnosis of type 1 diabetes
- Autoimmune thyroid disease
- Newly diagnosed chronic fatigue syndrome and irritable bowel syndrome
Dermatitis herpetiformis is included in other recommendations. The NICE also recommend offering serological testing for celiac disease in people with:
- Metabolic bone disease
- Unexplained neurological disorders
- Fertility problems or recurrent miscarriage
- Persistently raised liver enzymes with unknown cause
- Dental enamel defects and with diagnose of Down syndrome or Turner syndrome
What to eat if I have Celiac disease? (अगर मुझे सीलिएक रोग है तो क्या खाएं?)
Foods such as meat, fish, fruits, vegetables, rice, and potatoes without additives or seasonings do not contain gluten and are part of a well-balanced diet. You can eat gluten-free types of bread, pasta, and other foods that are now easier to find in stores, restaurants, and special food companies. You also can eat potato, rice, soy, amaranth, quinoa, buckwheat, or bean flour instead of wheat flour.
In the past, doctors and dietitians advised against eating oats if you have celiac disease. Evidence suggests that most people with the disease can safely eat moderate amounts of oats, as long as they did not come in contact with wheat gluten during processing. You should talk with your health care team about whether to include oats in your diet.
When shopping and eating out, remember to:
- Read food labels —especially on canned, frozen, and processed foods—for ingredients that contain gluten
- Identify foods labeled “gluten-free;” by law, these foods must contain less than 20 parts per million, well below the threshold to cause problems in the great majority of patients with celiac disease
- Ask restaurant servers and chefs about how they prepare the food and what is in it
- Find out whether a gluten-free menu is available
- Ask a dinner or party host about gluten-free options before attending a social gathering
Foods labeled gluten-free tend to cost more than the same foods that have gluten. You may find those naturally gluten-free foods are less expensive. With practice, looking for gluten can become second nature.
Celiac disease Treatment (सीलिएक रोग का इलाज)
Refractory disease (दुर्दम्य रोग)
Between 0.3% and 10% of people have a refractory disease, which means that they have persistent villous atrophy on a gluten-free diet despite the lack of gluten exposure for more than 12 months.
Celiac disease & Free Siddha energy remedies (सीलिएक रोग और नि:शुल्क सिद्ध ऊर्जा उपचार)