Celiac Disease: More Than Just Wheat Intolerance

Celiac disease (CD) is a complex condition often misunderstood as a simple wheat allergy. In reality, it’s far more intricate than that. Let’s delve into the key aspects of this condition:

1. CD: Not Your Average Wheat Allergy

  • Unlike a wheat allergy, celiac disease is a unique form of wheat intolerance.

2. Classical and Atypical CD

  • Classical celiac disease presents with symptoms like failure to thrive, chronic diarrhea, and abdominal fullness.
  • Atypical celiac disease showcases a range of symptoms, including anemia, short stature, abdominal pain, constipation, vomiting, skin issues, and more.

3. Screening Tests

  • IgATTG is the primary screening serological test used for CD.
  • TTG-DGP offers increased specificity, particularly for children under 2 years of age, while anti-endomycial antibodies are more specific for those over 2.

4. Role of HLA Markers

  • HLA markers do not influence gluten-free diet (GFD) recommendations and are typically advised when there’s uncertainty in the diagnosis.

5. Confirmatory Testing

  • According to current guidelines (excluding ESPGHAN guidelines), upper gastrointestinal endoscopy and D-2 biopsy are necessary for confirmation.

6. Importance of Separate Food Preparation

  • To ensure compliance with a gluten-free diet, having a separate grinder or flour mill is crucial.

7. Initial Lactose Avoidance

  • Initially, it’s advised to avoid milk as celiac disease can lead to secondary lactose intolerance.

8. Ongoing Research

  • Ongoing research explores various aspects of celiac disease, including vaccines, new wheat strains, immunosuppressants, and other treatments.

Understanding celiac disease is essential for accurate diagnosis and management. It’s a multifaceted condition that goes beyond wheat intolerance, impacting various aspects of health. Stay informed about the latest research and guidelines to provide the best care for individuals with celiac disease.

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