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Celiac Disease Presented By: Kasi Johnson { What is Celiac Disease? An Inherited, Autoimmune Disorder Permanent Intolerance to Gluten in Wheat, Rye, Barley Gluten is made of several different proteins (Ex: Gliadin and glutenin). In Celiac disease, gliadin is resistant to certain membrane proteases, and does not digest. Damages the villi of the small intestine Interferes with the nutrient absorption When people eat food that contains gluten, their immune system attacks their small intestine. Typically genetic: 1 in 10 chance Summary of Celiac Disease Celiac Disease What is Gluten? The Portion of the protein in flour that forms the structure of dough. What Actually Happens with Digestion Process?? Normal Digestion vs. Abnormal The Normal Digestion of Gluten The villi allow food to be absorbed through the walls of small intestine to the blood through endocytosis Proteins enter the small intestine. Pancreatic In a healthy microvilli, there are 650 per cell The Process of Celiac Disease The Effects What causes Celiac Disease? Abnormally permeable intestinal lining leaks gluten and initiates immune reaction in these will susceptible genes. The intestinal villi flatten out and the intestinal lining becomes inflamed. This is due to an autoimmune response to gliadin. Flattened villi cannot absorb nutrients, due to the decrease in surface area. This includes all nutrients, not just gluten related. This villi cannot produce digestive enzymes to breakdown food. The nuclei in diseased small intestinal cells show irregularity in size and position. Without healthy villi, a person becomes malnourished, despite food consumption because nutrients cannot cross the phospholipid bi-layer from the small intestine into the blood capillaries. Microvilli on Duodenal Villi can completely disappear Digestive enzymes of the S.I. are embedded within plasma membrane of the microvilli. The red box represents aminopeptidase, the enzyme that cleaves amino acids from polypeptide chains Examples of effects from lost enzymes: Free amino acids cannot be made by brush border enzymes and hydrolyzed within epithelial cells. Carbohydrates like maltose cannot be hydrolyzed into monosaccharides by brush border enzymes. Celiac Disease Destroys This Brush Border and Eliminates its Functions Celiac Stops These Processes: Goblet cells cannot secrete mucus. The capillaries cannot absorb monosaccharides and amino acids, nor house lymphocytes. The lacteal cannot absorb fat. Simple columnar epithelium lose microvilli. Microvilli loose enzymes that hydrolyze disaccharides and polypeptides. The Crypt cannot make new epithelial cells by mitosis Symptoms Gas and bloating. Changes in bowel movements. Weight loss. Feeling very tired. Weakness. Some may be asymptomatic Diarrhea Short Stature Iron Deficiency Anemia Lactose Intolerance Irritability Mood Swings Abdominal Pain Irritable Bowel Osteoporosis Skin rash-very itchy with blisters Sound Familiar? Get Checked out! See your doctor. Initial Blood Tests Avoid foods with gluten in it and see what happens. Treatment NOT CUREABLE: GLUTEN FREE DIET ELIMINATE ALL WHEAT, RYE, BARLEY 97% go undiagnosed; 6 months to 1 year if gluten is out of diet What Next? Learn how to watch what goes into body. Read Labels! Understand Cross Contamination Research Folders Words of Wisdom Website to locate local restaurant that have glutenfree options. Tips for reading labels Copy of PowerPoint Learn how to watch what goes into body. 1- GLUTEN CONTAINING GRAINS TO AVOID 2- OVERLOOKED GLUTEN SOURCES 3- GLUTEN FREE GRAINS AND STARCHES 4- GLUTEN FREE SHOPPING LIST GLUTEN CONTAINING GRAINS TO AVOID Barley Barley malt/extract Bran Bulgur Couscous Bromated or Durum Flour Einkorn Emmer Enriched or Self Rising Flour Farina Faro Graham Flour Kamut Phosphated Flour Rye Seltan Semolina Spelt Triticale (cross between wheat/rye) Udon Wheat OVERLOOKED GLUTEN SOURCES Ales Beer and Lagers Bouillon Cubes Breading Brown Rice Syrup Coating Mix Communion Wafers Croutons Candy Some Chips/Potato chips Luncheon Meats, hot dogs, salami, sausage French Fries Gravy Pasta Rice Mixes Seasoned Tortilla Chips Sauces Soup Base Stuffing Self-basting Poultry Imitation Bacon/Seafood Soy Sauce Marinades Thickeners Herbal Supplements, Prescription Meds Over the Counter Meds GLUTEN FREE GRAINS AND STARCHES Amaranth Arrowroot Buckwheat Corn Flax Flours made from nuts, beans and seeds Millet Montina Potato Starch Potato Flour Quinoa Rice Rice Bran Sago Sorghum Soy (soya) Tapioca Teff GLUTEN FREE SHOPPING LIST Sour Cream Plain Frozen Fruits/Veggies Most Ice Cream/Sherbet Potato Chips (beware flavored ones) Rice Crackers, Rice Cakes Jello Pudding Plain Canned Fruits/Veggies Canned Tuna or Chicken Dried Beans, Lentils, Peas Most Baked BeansFresh Fruits Fresh Vegetables Tofu Fresh Beef Fresh Pork Fresh Poultry (self-basting) Fresh Fish or Seafood Eggs Unflavored Milk Most Yogurts Butter, Margarine • • • • • • • • • • • • • • • • • • • • • • • Cream of Rice Grits Puffed Rice Plain Brown or White Rice CORN Tacos/Tortillas Ketchup Mustard Distilled Vinegars Most Salad Dressings Vegetable, Canola and Olive Oil Jams/Jellies, Marmalade Honey Peanut Butter Corn or Potato Starch Corn and Maple Syrup Brown, White and Confectioner’s Sugar Spices and Herbs Salt, Pepper Relish, Pickles, Olives Cream Cheese Cottage Cheese Corn Chips Popcorn Read Labels! Watch for Wheat, Barley, or Rye Not all food are obvious (watch for other words that mean wheat) - Bromated flour, farina, flour, plain flour, semolina If in doubt, look for “Gluten-Free” - Look at Handout in Folder for tips Time to Practice Understand Cross Contamination Cross contamination: 8 Tips For Avoiding Gluten Cross Contamination - Handout in Folder Happens when bacteria from one food item are transferred to another food item, often by way of unwashed cutting boards or countertops, as well as knives and other kitchen tools, or even unwashed hands. Cross contamination can in turn lead to food poisoning. Research Make time to “DO the research” Books, magazines, websites and more! Book: The G-Free Diet: A Gluten-Free Survival Guide By: Elisabeth Hasselbeck Questions or Comments?? Contact Info: Name Phone Number Email Sources http://www.ncbi.nlm.nih.gov/pubmed www.calgaryceliac.com/events/Celiac Disease in Children.ppt http://bnljceliacdisease.wordpress.com http://www.marshfieldclinic.org http://highered.mcgraw-hill.com http://www.nature.com http://www.scribd.com http://digestive.niddk.nih http://glutenfreeregistry.com/gluten-free-statesearch.do?state=MN&page=3 http://nutritioncaremanual.org/vault/editor/Docs/Ce liacLabelReadingTips_FINAL.pdf http://www.celiac.org/index.php?option=com_conte nt&view=article&id=3&Itemid=9