{"id":5416,"date":"2025-12-09T00:33:05","date_gmt":"2025-12-09T05:33:05","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&#038;p=5416"},"modified":"2026-01-12T18:38:38","modified_gmt":"2026-01-12T23:38:38","slug":"celiac-disease","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/celiac-disease\/","title":{"raw":"10p21  Celiac Disease","rendered":"10p21  Celiac Disease"},"content":{"raw":"<strong>Celiac Disease (Celiac Sprue, Gluten Enteropathy)<\/strong>\r\n<h1><strong>Overview<\/strong><\/h1>\r\n<ul>\r\n \t<li>An\u00a0<strong>autoimmune malabsorption syndrome<\/strong>\u00a0mainly affecting the\u00a0<strong>small intestine<\/strong>\u2014particularly the\u00a0<strong>duodenum<\/strong>\u00a0and\u00a0<strong>jejunum<\/strong>.<\/li>\r\n \t<li>Occurs when the immune system reacts to\u00a0<strong>gluten<\/strong>, damaging intestinal villi and impairing nutrient absorption.<\/li>\r\n<\/ul>\r\n<h1><strong>Causes and Risk Factors<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Genetic predisposition<\/strong>: Often runs in families.<\/li>\r\n \t<li><strong>Autoantibodies<\/strong>: The immune system produces antibodies that attack the intestinal lining.<\/li>\r\n \t<li><strong>Enzyme defect<\/strong>:\r\n<ul>\r\n \t<li>Impaired breakdown of\u00a0<strong>gliadin<\/strong>, a component of gluten.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Associated conditions<\/strong>:\r\n<ul>\r\n \t<li><strong>Type 1 diabetes<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Onset<\/strong>:\r\n<ul>\r\n \t<li>Usually during\u00a0<strong>childhood<\/strong>, but can occur in\u00a0<strong>adults<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Pathophysiology<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Immune attack<\/strong>\u00a0causes\u00a0<strong>atrophy<\/strong>\u00a0of intestinal villi:\r\n<ul>\r\n \t<li>Shortening and flattening of villi reduce surface area.<\/li>\r\n \t<li>Loss of villi diminishes the intestine\u2019s ability to absorb nutrients.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Consequences<\/strong>:\r\n<ul>\r\n \t<li><strong>Malabsorption<\/strong>\u00a0of multiple nutrients including fats, proteins, and minerals.<\/li>\r\n \t<li><strong>Steatorrhea<\/strong>: Fatty, greasy diarrhea.<\/li>\r\n \t<li><strong>Failure to thrive<\/strong>: Poor weight gain, muscle wasting.<\/li>\r\n \t<li><strong>Iron deficiency anemia<\/strong>.<\/li>\r\n \t<li>Nutritional deficits affect\u00a0<strong>brain function<\/strong>, causing\u00a0<strong>irritability<\/strong>,\u00a0<strong>fatigue<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Symptoms<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Onset<\/strong>: Usually when gluten-containing foods are introduced (4-6 months).<\/li>\r\n \t<li><strong>Signs<\/strong>:\r\n<ul>\r\n \t<li><strong>Diarrhea<\/strong>,\u00a0<strong>bloating<\/strong>,\u00a0<strong>steatorrhea<\/strong>.<\/li>\r\n \t<li><strong>Failure to gain weight<\/strong>.<\/li>\r\n \t<li><strong>Muscle loss<\/strong>.<\/li>\r\n \t<li><strong>Iron deficiency anemia<\/strong>.<\/li>\r\n \t<li><strong>Irritability, fatigue<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Long-term risks<\/strong>:\r\n<ul>\r\n \t<li>Increased likelihood of\u00a0<strong>intestinal lymphoma<\/strong>.<\/li>\r\n \t<li>Development of\u00a0<strong>osteoporosis<\/strong>\u00a0due to malabsorption of calcium and vitamin D.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Diagnosis<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Blood tests<\/strong>:\r\n<ul>\r\n \t<li>Check for\u00a0<strong>autoantibodies<\/strong>\u00a0(e.g., anti-tissue transglutaminase).<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Endoscopy with biopsy<\/strong>:\r\n<ul>\r\n \t<li>Visual confirmation of\u00a0<strong>villous atrophy<\/strong>.<\/li>\r\n \t<li>Biopsy supports diagnosis of intestinal damage.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Treatment<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Gluten-free diet<\/strong>:\r\n<ul>\r\n \t<li>Avoid\u00a0<strong>wheat, barley, rye, oats<\/strong>.<\/li>\r\n \t<li>Be aware of hidden gluten in processed foods.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Outcome<\/strong>:\r\n<ul>\r\n \t<li><strong>Villi<\/strong>\u00a0usually regenerate within weeks if diet is strict.<\/li>\r\n \t<li>Lifelong adherence required to prevent relapse and complications.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Visual Comparison<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Normal small intestine<\/strong>:\r\n<ul>\r\n \t<li>Numerous\u00a0<strong>villi<\/strong>\u00a0to maximize surface area.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Celiac disease<\/strong>:\r\n<ul>\r\n \t<li><strong>Flattened villi<\/strong>\u00a0with loss of absorptive surface.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>","rendered":"<p><strong>Celiac Disease (Celiac Sprue, Gluten Enteropathy)<\/strong><\/p>\n<h1><strong>Overview<\/strong><\/h1>\n<ul>\n<li>An\u00a0<strong>autoimmune malabsorption syndrome<\/strong>\u00a0mainly affecting the\u00a0<strong>small intestine<\/strong>\u2014particularly the\u00a0<strong>duodenum<\/strong>\u00a0and\u00a0<strong>jejunum<\/strong>.<\/li>\n<li>Occurs when the immune system reacts to\u00a0<strong>gluten<\/strong>, damaging intestinal villi and impairing nutrient absorption.<\/li>\n<\/ul>\n<h1><strong>Causes and Risk Factors<\/strong><\/h1>\n<ul>\n<li><strong>Genetic predisposition<\/strong>: Often runs in families.<\/li>\n<li><strong>Autoantibodies<\/strong>: The immune system produces antibodies that attack the intestinal lining.<\/li>\n<li><strong>Enzyme defect<\/strong>:\n<ul>\n<li>Impaired breakdown of\u00a0<strong>gliadin<\/strong>, a component of gluten.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Associated conditions<\/strong>:\n<ul>\n<li><strong>Type 1 diabetes<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Onset<\/strong>:\n<ul>\n<li>Usually during\u00a0<strong>childhood<\/strong>, but can occur in\u00a0<strong>adults<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Pathophysiology<\/strong><\/h1>\n<ul>\n<li><strong>Immune attack<\/strong>\u00a0causes\u00a0<strong>atrophy<\/strong>\u00a0of intestinal villi:\n<ul>\n<li>Shortening and flattening of villi reduce surface area.<\/li>\n<li>Loss of villi diminishes the intestine\u2019s ability to absorb nutrients.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Consequences<\/strong>:\n<ul>\n<li><strong>Malabsorption<\/strong>\u00a0of multiple nutrients including fats, proteins, and minerals.<\/li>\n<li><strong>Steatorrhea<\/strong>: Fatty, greasy diarrhea.<\/li>\n<li><strong>Failure to thrive<\/strong>: Poor weight gain, muscle wasting.<\/li>\n<li><strong>Iron deficiency anemia<\/strong>.<\/li>\n<li>Nutritional deficits affect\u00a0<strong>brain function<\/strong>, causing\u00a0<strong>irritability<\/strong>,\u00a0<strong>fatigue<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Symptoms<\/strong><\/h1>\n<ul>\n<li><strong>Onset<\/strong>: Usually when gluten-containing foods are introduced (4-6 months).<\/li>\n<li><strong>Signs<\/strong>:\n<ul>\n<li><strong>Diarrhea<\/strong>,\u00a0<strong>bloating<\/strong>,\u00a0<strong>steatorrhea<\/strong>.<\/li>\n<li><strong>Failure to gain weight<\/strong>.<\/li>\n<li><strong>Muscle loss<\/strong>.<\/li>\n<li><strong>Iron deficiency anemia<\/strong>.<\/li>\n<li><strong>Irritability, fatigue<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Long-term risks<\/strong>:\n<ul>\n<li>Increased likelihood of\u00a0<strong>intestinal lymphoma<\/strong>.<\/li>\n<li>Development of\u00a0<strong>osteoporosis<\/strong>\u00a0due to malabsorption of calcium and vitamin D.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Diagnosis<\/strong><\/h1>\n<ul>\n<li><strong>Blood tests<\/strong>:\n<ul>\n<li>Check for\u00a0<strong>autoantibodies<\/strong>\u00a0(e.g., anti-tissue transglutaminase).<\/li>\n<\/ul>\n<\/li>\n<li><strong>Endoscopy with biopsy<\/strong>:\n<ul>\n<li>Visual confirmation of\u00a0<strong>villous atrophy<\/strong>.<\/li>\n<li>Biopsy supports diagnosis of intestinal damage.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Treatment<\/strong><\/h1>\n<ul>\n<li><strong>Gluten-free diet<\/strong>:\n<ul>\n<li>Avoid\u00a0<strong>wheat, barley, rye, oats<\/strong>.<\/li>\n<li>Be aware of hidden gluten in processed foods.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Outcome<\/strong>:\n<ul>\n<li><strong>Villi<\/strong>\u00a0usually regenerate within weeks if diet is strict.<\/li>\n<li>Lifelong adherence required to prevent relapse and complications.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Visual Comparison<\/strong><\/h1>\n<ul>\n<li><strong>Normal small intestine<\/strong>:\n<ul>\n<li>Numerous\u00a0<strong>villi<\/strong>\u00a0to maximize surface area.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Celiac disease<\/strong>:\n<ul>\n<li><strong>Flattened villi<\/strong>\u00a0with loss of absorptive surface.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n","protected":false},"author":1370,"menu_order":24,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-5416","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":67,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5416","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":3,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5416\/revisions"}],"predecessor-version":[{"id":5419,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5416\/revisions\/5419"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/67"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5416\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=5416"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=5416"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=5416"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=5416"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}