Against the grain: an overview of celiac disease.
OBJECTIVE
To review the epidemiology, pathophysiology, clinical presentation, diagnosis, and management of celiac disease (CD).


METHODS
Review of literature using Pub Med and Access Medicine. The following search terms were used: celiac disease, malabsorption syndromes, diarrhea, and gluten-free diet (GFD). There was no limitation placed on publication year. Only articles written in English were included.


CONCLUSIONS
CD is a chronic systemic autoimmune disorder triggered in genetically susceptible individuals by the ingestion of gluten proteins (wheat, barley, and rye). CD often presents atypically, and diagnosis delays are common. Currently, the only effective treatment for CD is strict adherence to a GFD. This is a difficult diet to comprehend and follow. Adherence to a GFD requires ongoing education and support from a multidisciplinary healthcare team, support groups, family, and friends.


CONCLUSIONS
Once considered a rare disease of childhood, CD is now recognized as a common disorder that can occur at any age. Clinicians need to be cognizant of risk factors, clinical manifestations, conditions, and complications associated with CD in order to make a timely diagnosis, ameliorate symptoms, and minimize disease complications.
Martin
Suzanne
S
College of Nursing, University of Utah, Salt Lake City, Utah 84112, USA. suzanne.martin@shs.utah.edu
D000465:Algorithms; D001327:Autoimmune Diseases / Q000209:etiology; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis* / Q000178:diet therapy* / Q000453:epidemiology / Q000209:etiology; D003663:Decision Trees; D003937:Diagnosis, Differential; D004046:Dietetics; D005762:Gastroenterology; D020022:Genetic Predisposition to Disease / Q000209:etiology; D005983:Glutens / Q000009:adverse effects; D006801:Humans; D008487:Medical History Taking; D008612:Menu Planning; D009722:Nurse Practitioners / Q000458:organization & administration*; D009730:Nursing Assessment; D010348:Patient Care Team; D010349:Patient Compliance; D010353:Patient Education as Topic; D010808:Physical Examination; D011320:Primary Health Care / Q000379:methods; D012017:Referral and Consultation; D012307:Risk Factors; D012720:Severity of Illness Index; D012944:Social Support
D005983:Glutens