What causes Celiac disease

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Matthew is a 16-year-old male who has lost 20 pounds in the last few months because it seems that everything he eats disagrees with him. He used to love pizza, but now suffers from bloating, flatulence and diarrhea whenever he eats it. Hot dogs and even ranch dressing elicit the same symptoms. He can no longer tolerate milk. His mother is concerned because he seems pale and tired all the time and no longer enjoys playing basketball at the park with his brother. She makes an appointment with the family doctor who runs a series of tests. The results show that Matthew has Celiac disease and is now also anemic and lactose-intolerant.

Question 1: Explain to Matthew what causes Celiac disease, how it’s diagnosed, including what those results would show, and how this disease is treated. You will need to defend your answer using specific facts, data, and other information drawn from the textbook and at least one other supplemental source.

John is a sedentary 60-year-old male who wants to lose 15 pounds. His usual diet is moderate in protein, some vegetables like potatoes and carrots, and whole grains and cereals. He’s decided that to lose weight, he’ll cut down on carbohydrates in his diet, and increase the protein content. However, John doesn’t want to give up his Starbuck’s caramel latte in the morning, so the coffee and two boiled eggs are his usual breakfast. His favorite lunch is a cheese burger, sans bun, with two slices of tomato and half of a small order of French fries. For dinner, he usually has a chicken breast with a small side salad. John is losing weight, but he’s now experiencing constipation and severe cramping.

Question 2: Analyze John’s current diet and explain how it can affect his GI microbiome and overall GI tract health. Discuss in your answer some dietary components promote the growth of beneficial GI tract bacteria and the benefits these bacteria convey. Support your answer with data, facts, key terminology, specific examples and other information drawn from the textbook and at least one other supplemental source.

Sample Solution

Explanation for Matthew:

Hey Matthew, it sounds like you’ve been going through a lot lately with your digestive issues. I’m glad your mom took you to the doctor, and it’s good you now know what’s causing the trouble. You have Celiac disease, an autoimmune condition where your immune system mistakenly attacks your small intestine when you eat gluten.

Causes and Diagnosis:

Gluten is a protein found in wheat, barley, and rye. In your case, when you eat gluten, your immune system sees it as a threat and attacks the lining of your small intestine. This damages the villi, tiny hair-like structures that absorb nutrients from food. Over time, this damage prevents your body from properly absorbing vitamins, minerals, and other essential nutrients.

The doctor diagnosed you with Celiac disease through several tests, likely including:

  • Blood tests: These can detect antibodies your body produces in response to gluten.
  • Endoscopy: A thin, flexible tube with a camera is inserted through your mouth to examine your small intestine for damage.
  • Biopsy: A small tissue sample is taken from your small intestine during the endoscopy and examined under a microscope for signs of Celiac disease.

Treatment:

The good news is, Celiac disease is entirely manageable! The only treatment for Celiac disease is a strict gluten-free diet. This means completely avoiding all foods containing wheat, barley, and rye. It’s important to read labels carefully and be aware of hidden sources of gluten, like in sauces, processed foods, and medications.

Following a gluten-free diet for life will allow your small intestine to heal, improve nutrient absorption, and alleviate your symptoms of bloating, flatulence, diarrhea, fatigue, and anemia. With careful management, you can live a healthy and active life even with Celiac disease.

Sources:

Bonus Information:

  • Matthew’s lactose intolerance is likely a secondary effect of Celiac disease and should improve with a gluten-free diet.
  • He may need iron supplements to address his anemia initially.

Question 2: John’s Diet and Gut Health

Analysis of John’s Diet:

John’s weight loss through a low-carb, high-protein diet is likely due to reduced calorie intake overall. However, this approach has potential drawbacks for his gut health:

  • Low fiber intake: John’s diet relies heavily on animal protein and lacks enough fiber. Fiber, found primarily in fruits, vegetables, and whole grains, is essential for feeding beneficial gut bacteria. These bacteria promote nutrient absorption, improve digestive function, and support overall gut health.
  • Limited bacterial diversity: Lack of variety in food sources can lead to a less diverse gut microbiome, making him more susceptible to gut problems like constipation and cramping. A diverse microbiome includes different types of bacteria, each with specific functions, creating a more resilient and balanced gut ecosystem.
  • Insufficient hydration: Carbs also play a role in water retention. A drastic reduction in carbs might contribute to dehydration, further worsening constipation.

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