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Celiac disease



Related Terms
  • Antibodies, antibody, autoantibodies, autoantibody, autoimmune, autoimmune disease, autoimmune disorder, autoimmunity, biopsy, celiac, coeliac disease, cornmeal, digestive tract, endoscope, endoscopy, GFD, gluten, gluten-free, gluten-free diet, immune, immune defense system, immune reaction, immune response, immune system, intestinal lining, intestine, malabsorption, nutrient deficiency, potato flour, rice flour, vitamin deficiency, wheat.

Background
  • Celiac disease, also called celiac sprue, is a digestive disorder that occurs when an individual's immune system overreacts to the protein gluten, or other proteins within gluten such as gliadin, found in grains including wheat, rye, barley, and to some degree, oats. When a patient with the disease eats food that contains gluten, the immune system's response damages the intestinal lining. This causes symptoms of abdominal pain and bloating after consuming gluten.
  • Additionally, complications, including poor absorption, may occur if the patient continues to eat gluten-containing foods. When the intestinal lining is damaged, patients have difficulty absorbing nutrients.
  • It has not been determined what triggers this reaction in celiac patients. However, celiac disease is associated with autoimmune disorders, such as lupus. Autoimmune disorders occur when the patient's immune system mistakenly identifies body cells as harmful invaders, such as bacteria. As a result, the immune cells in celiac patients attack the patient's intestinal cells.
  • Researchers at the National Digestive Diseases Information Clearinghouse (NDDIC) estimate that one out of 133 people in the United States have the disease. Prevalence is even higher, one out of 22 people, among patients who have immediate family members (parent or sibling) who have the disease. This suggests that the disease may be inherited (passed down through families) in some cases.
  • Individuals can develop the disease at any age, but it is most commonly diagnosed in patients who are eight to 12 months old or in patients ages 30-40.
  • Although there is currently no cure for celiac disease, the condition can be managed with a gluten-free diet. In general, patients who strictly follow a gluten-free diet can expect to live normal, healthy lives. Symptoms will subside in several weeks and patients will be able to absorb food normally once they avoid eating gluten. A dietician or certified nutritionist may help a patient with celiac disease develop a healthy diet. Patients with celiac disease may also find gluten-free cookbooks to be a helpful resource. Many products, including rice flour and potato flour, can be used as substitutes for gluten.

Complications
  • Nutritional deficiencies: When a patient with celiac disease consumes gluten, the immune cells attack enzymes in the intestine that are needed for digestion and absorption of nutrients. Therefore, nutritional deficiencies are a complication of untreated celiac disease. Children may experience stunted growth if they are not receiving enough nourishment.
  • Patients who continue to eat gluten despite their condition may develop anemia (low levels of iron in the blood) because they are unable to absorb iron, folic acid, or vitamin B12.
  • Patients who continue to eat gluten often have low levels of vitamin K and D because they are normally absorbed in the intestine. Vitamin K is needed for the production of blood clotting factors. Patients with vitamin K deficiency have an increased risk of bleeding. Patients with vitamin D deficiency may have low levels of calcium in the blood, which may lead to bone disorders such as osteoporosis (hollow, brittle bones).
  • If left untreated, poor nutrition can potentially be fatal.
  • Other disorders: Celiac disease is associated with autoimmune disorders. The most common autoimmune disorders associated with the disease are lupus erythematosus, type I diabetes, rheumatoid arthritis, thyroid disease, and microscopic colitis (inflammation of the colon). The prognosis for patients with co-existing autoimmune disorders depends on the specific disorder. Most autoimmune disorders are chronic. However, many disorders can be managed with treatment such as immunosuppressants and anti-inflammatories.

Integrative therapies
  • Note: There is currently a lack of available scientific evidence on the use of integrative therapies for the treatment or prevention of celiac disease. The therapies listed below should be used only under the supervision of a qualified healthcare provider, and should not be used in replacement of other proven therapies or preventive measures.
  • Fair negative scientific evidence:
  • Zinc: In a very small study, oral zinc supplements did not seem to improve the clinical condition of patients with unresponsive celiac disease.
  • Zinc is generally considered safe when taken at the recommended dosages. Avoid zinc chloride since studies have not been done on its safety or effectiveness. Avoid with kidney disease. While zinc appears safe during pregnancy in amounts lower than the established upper intake level, caution should be used since studies cannot rule out the possibility of harm to the fetus.
  • Traditional or theoretical uses, which lack sufficient evidence:
  • Carob: Carob (Ceratonia siliqua) is a leguminous evergreen tree of the family Leguminosae (pulse family). Although carob has traditionally been used as a replacement for gluten, there is currently a lack of human studies on the safety and efficacy of the use of carob for celiac disease.
  • Avoid if allergic/hypersensitive to carob (Ceratonia siliqua), its constituents, or any plants in the Fabaceae family, including tamarind. Avoid with metabolic disorders, with a chromium, cobalt, copper, iron, or zinc disorder or deficiency, kidney disorders, or acute diarrhea. Avoid in underweight infants. Use cautiously in patients with anemia, known allergy to peanuts and other nuts, complications with powdered bulk forming laxative drinks, diabetes, or hyperlipidemia (high cholesterol). Use cautiously if taking oral herbs or drugs. Use cautiously in hypouricemic patients. Avoid if pregnant or breastfeeding.
  • Pantothenic acid (vitamin B5): Pantothenic acid (vitamin B5) is essential to all life and is a component of coenzyme A (CoA), a molecule that is necessary for numerous vital chemical reactions to occur in cells. Traditionally, pantothenic acid (vitamin B5) has been used to treat celiac disease, but scientific studies have not been conducted to evaluate the safety and efficacy of this treatment. Human scientific studies are needed before a firm conclusion can be made.
  • Avoid if allergic or hypersensitive to pantothenic acid or dexpanthenol. Avoid with gastrointestinal blockage. Pantothenic acid is generally considered safe in pregnant and breastfeeding women when taken at recommended doses.
  • Quinoa: Quinoa has been cultivated in the Andes Incas for thousands of years. Quinoa has been used as a substitute for wheat, especially by those on a gluten-free diet due to celiac disease or other conditions. However, human research is lacking.
  • Avoid if allergic or hypersensitive to quinoa (Chenopodium quinoa), its constituents, or members of the Amaranthaceae family. Use unwashed quinoa cautiously because it is naturally coated with saponins. Avoid if pregnant or breastfeeding.
  • Spleen extract: Spleen extract primarily comes from the spleens of cows or pigs. Although spleen extract has been used to treat celiac disease, scientific studies have not been conducted to evaluate the safety and efficacy of this treatment.
  • Avoid if allergic or hypersensitive to spleen extract or its components, including tuftsin. Use cautiously if taking analgesics, anticoagulants/antiplatelet agents, bestatin, chemotherapy drugs, or psychotropic drugs. Use cautiously with bleeding disorders with Hodgkin's disease, leukemia, or systemic lupus erythematosus. Use cautiously in children and in patients with weakened immune systems. Avoid if taking immunosuppressants. Avoid spleen extract from countries where bovine spongiform encephalitis (BSE or "mad cow disease") has been reported. Avoid if pregnant or breastfeeding.
  • Vitamin K: Vitamin K is found in green leafy vegetables like spinach, broccoli, asparagus, watercress, cabbage, cauliflower, green peas, beans, olives, canola, soybeans, meat, cereals, and dairy products. Although vitamin K deficiency is rare, patients who have celiac disease have an increased risk of developing this condition. Therefore, vitamin K has been suggested as possible treatment for patients with celiac disease. However, there are currently no human studies available on the safety and efficacy of this treatment.
  • Avoid if allergic or hypersensitive to vitamin K. Injection into the muscle or vein should only be done by a healthcare professional. Many serious side effects have occurred after injection. Menadiol (type of vitamin K that is not available in the United States) should be avoided with glucose-6-phosphate dehydrogenase deficiency. Avoid if pregnant. The American Academy of Pediatrics recommends giving a single vitamin K1 injection into the muscle to all newborns to prevent vitamin K deficiency bleeding (VKDB). However, large amounts of vitamin K may cause serious side effects or death. Vitamin K is generally considered safe for breastfeeding mothers.

Author information
  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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