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Celiac Disease
Presented By:
Kasi Johnson
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What is Celiac Disease?
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An Inherited, Autoimmune Disorder
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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
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Interferes with the nutrient absorption
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When people eat food that contains gluten, their immune system attacks their
small intestine.
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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
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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.
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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
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Folders
Words of Wisdom
Website to locate local
restaurant that have glutenfree options.
Tips for reading labels
Copy of PowerPoint
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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
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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
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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
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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
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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
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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
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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
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Questions or Comments??
Contact Info:
Name
Phone Number
Email
Sources
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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