Thursday 20 September 2007

Prognosis & Complications of Celiac Disease

Prognosis

Prognosis for celiac disease is generally good. For most people, following a gluten-free diet plan will stop symptoms, heal existing intestinal damage, and prevent further damage. Improvements begin within days of starting the diet. The small intestine is usually completely healed in 3 to 6 months in children and younger adults and within 2 years for older adults. Healed means a person now has villi that can absorb nutrients from food into the bloodstream.

However, sometimes, depending on a person’s age at diagnosis, some problems will not improve, such as delayed growth and tooth discoloration. For example, young patients who are diagnosed with celiac disease after their growth period will continue to have a short stature.

Some people with celiac disease show no improvement on the gluten-free diet. This condition is called unresponsive celiac disease. The most common reason for poor response is that small amounts of gluten are still present in the diet. Advice from a dietitian who is skilled in educating patients about the gluten-free diet is essential to achieve the best results.

Rarely, the intestinal injury will continue despite a strictly gluten-free diet. People in this situation have severely damaged intestines that cannot heal. Because their intestines are not absorbing enough nutrients, they may need to receive nutrients directly into their bloodstream through a vein, or intravenously. People with this condition may need to be evaluated for complications of the disease. Researchers are now evaluating drug treatments for unresponsive celiac disease.

Complications of celiac disease

Complications of Celiac Disease are secondary conditions, symptoms, or other disorders that are caused by Celiac Disease. In many cases the distinction between symptoms of Celiac Disease and complications of Celiac Disease is unclear or arbitrary.

Damage to the small intestine and the resulting nutrient absorption problems put a person with celiac disease at risk for several diseases and health problems.

Some of the more common ones are listed below:

· Anaemia caused mainly by deficiencies in iron and vitamin B12 absorption.
· Lymphoma and adenocarcinoma are cancers that can develop in the intestine.
· Osteoporosis caused by poor calcium absorption.
· Miscarriage and congenital malformation of the baby, such as neural tube defects, are risks for pregnant women with untreated celiac disease because of nutrient absorption problems.
· Short stature results when childhood celiac disease prevents nutrient absorption during the years when nutrition is critical to a child’s normal growth and development. Children who are diagnosed and treated before their growth stops may have a catch-up period.
· Seizures, or convulsions, result from inadequate absorption of folic acid. Lack of folic acid causes calcium deposits, called calcifications, to form in the brain, which in turn cause seizures.

Contributed by John Lee

Sources:

National Institute of Diabetes and Digestive and Kidney Diseases (US):
http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/#6

WrongDiagnosis.com:
http://www.wrongdiagnosis.com/c/celiac_disease/complic.htm

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