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Celiac DiseasePresented By:Kasi Johnson

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

What is Celiac Disease?

Celiac Disease

Summary of Celiac Disease

The Portion of the protein in flour that forms the structure of

dough.

What is Gluten?

What Actually Happens with Digestion

Process??Normal Digestion vs. Abnormal

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 Normal Digestion of Gluten

The Process of Celiac Disease

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.

The Effects

Microvilli on Duodenal Villi can completely disappearDigestive 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

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

Celiac Stops These Processes:

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

Symptoms

See your doctor.Initial Blood TestsAvoid foods with gluten in it and see what happens.

Sound Familiar? Get Checked out!

NOT CUREABLE: GLUTEN FREE DIETELIMINATE ALL WHEAT, RYE, BARLEY97% go undiagnosed; 6 months to 1 year if

gluten is out of diet

Treatment

Learn how to watch what goes into body.

Read Labels!Understand Cross Contamination

Research

What Next?

Words of Wisdom Website to locate local restaurant that have gluten-free options.

Tips for reading labelsCopy of PowerPoint

Folders

1- GLUTEN CONTAINING GRAINS TO AVOID2- OVERLOOKED GLUTEN SOURCES3- GLUTEN FREE GRAINS AND STARCHES4- GLUTEN FREE SHOPPING LIST

Learn how to watch what goes into body.

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

GLUTEN CONTAINING GRAINS TO AVOID

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

OVERLOOKED GLUTEN SOURCES

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 GRAINS AND STARCHES

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

GLUTEN FREE SHOPPING LIST • 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

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

Read Labels!

Time to Practice

Understand Cross Contamination

8 Tips For Avoiding Gluten Cross

Contamination

- Handout in Folder

Cross contamination:

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.

Make time to “DO the research” Books, magazines, websites and

more! Book: The G-Free Diet: A Gluten-Free

Survival Guide By: Elisabeth Hasselbeck

Research

Contact Info: NamePhone Number Email

Questions or Comments??

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-state-search.do?state=MN&page=3

http://nutritioncaremanual.org/vault/editor/Docs/CeliacLabelReadingTips_FINAL.pdf

http://www.celiac.org/index.php?option=com_content&view=article&id=3&Itemid=9

Sources