2. INTRODUCTION
Celiac disease also known as coeliac disease, It is an
autoimmune disorder of the small intestine that occurs
in genetically predisposed people of all ages from middle
infancy. Celiac disease is caused by a reaction to gliadin, a
gluten protein found in wheat, rye and barley .
3. DEFINITION
Celiac disease is an autoimmune disorder where the
ingestion of gluten leads to damage in small intestine.
4. INCIDENCE
• It is estimated to affect 1 in 100 people world wide.
• Prevalence was 4% in South America 0.5%in Africa and 0.6% in
Asia.
Prevalence in children between 2.5 and 15 years of age
• 3-13/1000 children
• Approximately 1 in 300 to 1 in 80 children.
5. RISK FACTORS
• A Family member with celiac disease.
• Type 1 diabetes mellitus
• Down syndrome or Turner syndrome
• Adisson’s disease
• Rheumatoid arthritis
6. PATHOPHYSIOLOGY
• Celiac disease occurs from an interaction between genes, eating
foods with gluten and other environmental factors, but the
precise cause isn’t known.
• When the body’s immune system over reacts to gluten in food.
• The reaction damages the tiny hair like projections (villi) that
line the small intestine.
• Villi absorbs vitamins, minerals &other nutrients from the food.
• If the villi get damaged, child didn’t get enough nutrients.
7. CLINICAL MANIFESTATION
In Children under 2 years of age, the typical signs and symptoms
include,
1. Vomiting
2. Chronic diarrhoea
3. Swollen belly
4. Failure to thrive
5. Poor appetite
6. Muscle wasting
11. MEDICAL MANAGEMENT
Pharmacological Management
Mineral and vitamin supplements (treat nutritional problems)
Enzyme Therapy
Folate supplements
Iron supplements
dapsone, (taken by mouth, can control the skin symptoms).
(Exactly There is no medication that treats celiac disease).
15. CONTI...
Nursing Intervention
• Eliminate gluten from the diet.
• Give the child corn and rice products, soy and potato,flour,
breast milk or soy-based formula, and fresh fruits.
• Replace vitamins and calories; give small, frequent meals.
• Monitor for steatorrhea - its disappearance is a good indicator
that the child's ability to absorb nutrients is improving.
• Maintain fluid volume within normal limits
16. PATIENT TEACHING
Be sure to cover:
• the disease and signs and symptoms of complications
• the importance of following a gluten-free diet
• that the child’s weight should return to within a normal range
within 6 months to 1 year after starting the diet
• how to read food labels and to avoid products with hidden
gluten content such as food containing “vegetable protein.”
18. COMPLICATIONS
• Intestinal T- cell lymphoma
• Carcinoma of small intestine
• Ulcerative jejunitis
• Complicationa of nutritional deficiency
1. Anemia, peripheral neuropathy
2. Osteomalacia, osteoporosis
19. CONCLUSION
Celiac disease is an autoimmune inflammatory disorder of the
small intestine triggered by gluten, and is a very common chronic
disease A gluten-free diet typically reverses all signs and
symptoms within a short time.Monitoring of the patient to verify
ongoing dietetic compliance is fundamental in order to ensure
that all possible complications, including malignancies, are
avoided.
