COELIAC DISEASE

Coeliac Disease and Its Diagnosis

Coeliac Disease and Its Diagnosis

IntroductionCoeliac (or Celiac) disease is an autoimmune disease characterized by chronic inflammation of the proximal part of the small intestine, or jejunum (Schupann, Junker, Barisani 2009). The disease is caused by exposure to gliadin. Glaiadin is a protein found in some cereals in the diet. Gliadin is a component of gluten (protein found in wheat, the barley, the rye, the triticale, the kamut, the buckwheat and possibly oats -for cross-contamination issues-). Under normal conditions all food eaten must go through a digestion process that degrades into smaller particles so that they can then be absorbed. This absorption of food takes place in the small intestine (Gonzalez, Gupta, Cheng, Tennyson, Lewis et al, 2010).It is a disorder that occurs in genetically predisposed people of all ages from childhood. The symptoms include diarrhea, chronic growth retardation and / or child development, fatigue, skin rashes, weight loss, mood swings, vomiting and swollen belly. Although these symptoms may be absent and appear from time to time, they can appear in any of almost all organs and body systems (Weir, Glickman, Roiffé, Valim, Leichtner 2010). It is estimated that the disease affects 1% of the population of Indo-European languages, but is thought to be a significantly under-diagnosed disease.

As a result of early testing, we are seeing an increasing number of diagnosed asymptomatic (Schupann, Junker, Barisani 2009). The only effective treatment is switching to a diet free of gluten for life and allowing regeneration of the intestinal villi. Although the disorder is caused by a reaction to wheat proteins, it is not the same as an allergy to wheat. The proper term is gluten intolerance, gluten-sensitive enteropathy, non-tropical endemic sprue and celiac sprue. The term "celiac" comes from the Greek koiliakos, meaning abdominal (Ravelli, Villanacci, Monfredini, Martinazzi, Grassi, Manenti 2010).It can occur at any stage of life. Although it is usually diagnosed in childhood, increasing number of adults are diagnosed in developed countries. It is more common in white skinned people of the tropical climates. In order to develop the disease, there must be a genetic predisposition and a trigger. In the case of women, the trigger can be the first or any abdominal intervention.It is a disease of genetic origin but not hereditary (Prasad, Thapa, Nain, Singh 2009). However, the fact that a person has the disease makes it more likely that their family's suffering, compared to the general population. Coeliac disease is often a missed condition at diagnosis. This paper provides an overview of the disease's pathogenesis. Specifically, the paper examines the role of histopathology and immunohistochemistry in the diagnosis of this disease.PathogenesisWhen exposed to gliadin, the enzyme tissue transglutaminase modifies the protein and the immune system of the individual making a cross-reaction against the small intestine, causing an inflammatory reaction that causes atrophy of the villi lining of the gut. This reaction interferes with the absorption of nutrients.Due to changes in the structure and function of the mucosa of the small intestine, the body loses the ability to digest and absorb nutrients from food. The main cause of Celiac disease is a reaction to immune mediated cells to components of ...