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Celiac disease is a disease of the digestive system in which the inside lining of the small intestine (mucosa) is damaged after eating wheat, rye, oats, or barley, resulting in interference with the absorption of nutrients from food.
Celiac disease occurs when the body reacts abnormally to gluten, a protein found in grains, including wheat, rye, barley, and possibly oats. When someone with celiac disease eats foods containing gluten, that person's immune system causes an inflammatory response in the small intestine, which damages the tissues and results in impaired ability to absorb nutrients from foods (malabsorption). The inflammation and malabsorption create wide-ranging problems in many systems of the body. Since the body's own immune system causes the damage, celiac disease is classified as an autoimmune disorder.
Each person with celiac disease is affected differently. When food containing gluten reaches the small intestine, the immune system begins to attack a substance called gliadin, which is found in the gluten. The resulting inflammation causes damage to the delicate finger-like structures in the intestine, called villi, where food absorption actually takes place. This damage is referred to as villus atrophy. The patient may experience a number of symptoms related to the inflammation and the chemicals it releases, and/or the lack of ability to absorb nutrients from food, which can cause malnutrition.
Celiac disease may be discovered at any age, from infancy through adulthood. The disorder is more commonly found among white Europeans and in people of European descent. It is very unusual to find celiac disease in African or Asian people. The exact incidence of the disease is uncertain. Estimates vary from one in 5,000, to as many as one in every 300 individuals with this background. The prevalence of celiac disease seems to be different from one European country to another and between Europe and the United States. This discrepancy may be due to differences in diet and/or the possibility that the disease goes unrecognized in some areas. One study of random blood samples tested for celiac disease in the United States showed one in 250 testing positive. It is clearly underdiagnosed, probably because the symptoms are attributed to another problem, and physicians and laboratory technicians lack knowledge about celiac disease.
Because celiac disease has a hereditary influence or genetic component, close relatives (especially first-degree relatives, such as children, siblings, and parents) have a higher risk of being affected with the condition. The chance that a first-degree relative of someone with celiac disease has the disease is about 10 percent.
Author Info: Judith Sims MS, Amy Vance MS, CGC, Thomson Gale, Gale, Detroit, Gale Encyclopedia of Children's Health, 2006
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