The Widening Spectrum of Celiac Disease

Celiac Disease or Celiac Sprue is a chronic autoimmune disorder with a genetic component. gliadin is a protein found in wheat, rye and barley. Ingestion by genetically susceptible individuals, under certain conditions such as surgery, infection, or severe emotional stress can trigger the onset of Celiac Disease, the production of anti-gliadin antibodies, which destroy the villi lining the lower intestines. This is where most of the nutrients for sustenance are absorbed and hence can lead to malnutrition, diarrhea, anemia and fatigue; the villi gradually get restored, only upon exclusion of gluten from the diet. What was once only thought to be a childhood gastrointestinal affliction is now known to be multi-systematic in nature, the exact physiologic mechanism is yet to be identified though anti-body production, chronic inflammation and cytokine cascades are acknowledged. This reaction can perpetuate a myriad of symptoms, regardless of age from Dermatitis Hepretiformis to migraines. Since the advent of endoscopy, serologic and genetic testing Celiac Disease is readily diagnosable, yet it remains underdiagnosed despite affecting one percent of today’s ‘healthy’ population. Due to this immune-mediated pathology, seemingly unrelated symptoms go unnoticed leading to a misdiagnosis or diagnosis of the symptom, especially when one presents without gastrointestinal symptomology. Despite a recognized immune mediated pathology Celiac Disease is often overlooked and notoriously thought of as merely a disease of the gut. Exploring the research on the extra intestinal manifestations widens the spectrum of Celiac disease, and proves quite clinically significant as Celiac Disease is on the rise