Gastroenterology

ACG develops first guideline for irritable bowel syndrome

(HealthDay)—In a new American College of Gastroenterology clinical guideline, published online Dec. 14 in The American Journal of Gastroenterology, recommendations are presented for diagnostic testing and therapeutic options ...

Gastroenterology

Arthritis drug could let coeliac patients eat gluten

Tofacitinib, a Janus kinase inhibitor approved to treat rheumatoid arthritis and bowel diseases, may allow patients with celiac disease to eat gluten without experiencing intestinal and extraintestinal symptoms. A case report ...

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Coeliac disease

Coeliac disease (pronounced /ˈsiːli.æk/), also spelled celiac disease, is an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages from middle infancy on up. Symptoms include chronic diarrhoea, failure to thrive (in children), and fatigue, but these may be absent, and symptoms in other organ systems have been described. A growing portion of diagnoses are being made in asymptomatic persons as a result of increased screening.

Coeliac disease is caused by a reaction to gliadin, a gluten protein found in wheat (and similar proteins of the tribe Triticeae, which includes other cultivars such as barley and rye). Upon exposure to gliadin, the enzyme tissue transglutaminase modifies the protein, and the immune system cross-reacts with the small-bowel tissue, causing an inflammatory reaction. That leads to a truncating of the villi lining the small intestine (called villous atrophy). This interferes with the absorption of nutrients, because the intestinal villi are responsible for absorption. The only known effective treatment is a lifelong gluten-free diet. While the disease is caused by a reaction to wheat proteins, it is not the same as wheat allergy.

This condition has several other names, including: cœliac disease (with œ ligature), c(o)eliac sprue, non-tropical sprue, endemic sprue, gluten enteropathy or gluten-sensitive enteropathy, and gluten intolerance. The term coeliac derives from the Greek κοιλιακός (koiliakόs, "abdominal"), and was introduced in the 19th century in a translation of what is generally regarded as an ancient Greek description of the disease by Aretaeus of Cappadocia.

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