31 Possible Causes of Abdominal Bloating and Abdominal Pain 7. Gluten and celiac spruce diseasePresentation Transcript
31 Possible Causes of Abdominal
Bloating and Abdominal Pain
7. Gluten and Celiac
Dr Yousef Elshrek
•Definition of Celiac disease, or celiac spruce
• Celiac disease, or celiac spruce defined, as a chronic
disorder of the small intestine caused by sensitivity to
• It causes poor absorption by the intestine of fat, protein,
carbohydrates, iron, water, and vitamins A, D, E, and K
• In another words , Celiac Spruce Disease is a problem of
malabsorption of certain proteins in the diet, mainly gluten
• Or Celiac disease is an autoimmune disorder characterized
by systemic inflammation resulting from the consumption of
the protein gluten.
• Of particular focus is the effect of inflammation on the
intestinal villi, which shrink and atrophy( weaken) over
time, and lead to chronic malnutrition.
•What is gluten ?
• Gluten is a combination of the natural proteins found in
wheat, and to much a lesser extent, in rye and barley.
• Gluten molecules are activated when flour is moistened and
then either kneaded or mixed.
• When this happens, the glutens literally stretch out.
• Then, the gases produced by yeast or another leavening
agent inflate these gluten molecules like little balloons,
which is what permits doughs to rise.
• Finally, when the dough is baked, the gluten hardens,
giving the bread its structure.
• Gluten is composed of about 75-86%
protein, while the other components are
carbohydrates and lipids; however,
these are held within the gluten-protein
• gluten is made up of the protein
fractions, glutenin and gliadin.
• Glutenin is a tough and rubbery mass
upon hydration, while gliadin becomes
a viscous, fluid mass.
• This is what allows gluten to exhibit
both elastic and viscous properties in
dough and lends to its properties of
extensibility, resistance to stretch,
mixing tolerance, and gas holding
• Gluten is a complex protein formed of
two protein structures, Gliadin and
Glutenin, connected by disulfide
• In bread and other baked goods,
yeasts consume sugar and produce
carbon dioxide via fermentation.
• The carbon dioxide becomes trapped
in this molecular mesh structure of
gluten, causing bread to “rise.”
• In patients with Celiac Disease,
consumption of this protein leads to
inflammation and severely impacts
The long, complex strands of glutenin and the
relatively compact gliadin combine to create a
molecular mesh that we call gluten
• While often targeted as a symptom of an injury that must be relieved,
inflammation is actually the bodies’ way of initiating the healing
• Muscle. Inflammation is generally divided into two categories: acute
• Acute inflammation is the immediate response to an injury, and
can be characterized by the sensation of heat, redness, swelling, pain
and decreased mobility.
• This results from the swelling of the blood vessles in the damaged
region, increasing both blood flow and the permeability of certain
blood vessels, allowing for the fast movement of fluids into and out
of the affected area.
• Acute inflammation has a short duration, lasting at most a few days,
and either resolves with the injury, or becomes chronic inflammation.
• Chronic inflammation is the long-term inflammatory response
that results from one of three possible sources.
1. A cause of acute inflammation may remain, failing to resolve the
bodies inflammatory response.
2. An irritant may be present that persists, and is of low intensity.
3. Finally, chronic inflammation can result from an autoimmune
response where the body mistakenly attacks itself.
4. Chronic inflammation can present in a manner similar to acute
inflammation, or it can present with no visible symptoms at all.
5. In celiac disease, the patient is affected by chronic inflammation,
specifically of the small intestine and intestinal villi.
• Intestinal Villi
• Intestinal villi are structural projections that
line the inside wall of the small intestine.
• These projections, or folds, are responsible
for the absorption of nutrients in digested
food (See “Cause” for a breakdown of the
cellular biology responsible for this
• In celiac disease, the affected villi shrink
and atrophy as a response to chronic
inflammation of the small intestine.
• The damage of these intestinal villi leads
to digestive problems and eventually
• Individuals with Celiac Spruce Disease have a lifelong
intolerance to the gliadin fraction of wheat as well as the
prolamins secalin (rye), hordeins (barley), and avidins
• The primary method treatment of this disease is through
the complete omission of foods containing gluten.
• Celiac Spruce Disease impairs intestinal absorption and
can lead to severe malnutrition.
• Celiac Spruce Disease affects the small intestine which, in
turn, prevents in the absorption of several important
nutrients including iron, folic acid, calcium and fat soluble
• The only way to ensure a life free of complications is to
adhere strictly to a 100% gluten-free diet
•What is Gluten Free Flour?
• Gluten free flour is a term that is applied to
flours that are made of non-gluten containing
• There are many kinds of gluten free flours
available at supermarkets these days, along
with many “all purpose” gluten free flour
blends that are designed to be an easy to use
replacement for wheat flour.
• Commercially available gluten free flours are
all made with different mixtures and these
mixtures vary widely from brand to brand.
• They might contain rice flour, teff flour,
tapioca flour, sorghum flour, potato starch,
garbanzo flour or buckwheat flour – just to
name a few of the many options that could be
a foundation for a gluten free flour blend.
• These flours could also contain nut
flours, made from very finely ground
almonds or other nuts.
• Xanthan gum is a binder that is
frequently added to gluten free flour
mixes to give the flour some
elasticity and make it easy to use
right out of the bag.
• Since the base ingredients for gluten
free flour can be very different,
different brands can produce very
different results in baked goods,
giving a recipe a completely different
taste and texture.