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COELIAC DISEASE

المؤلف:  FRANK GARVEY AND JACKY VINCENT

المصدر:  Caring for People with Learning Disabilities

الجزء والصفحة:  P128-C8

2025-10-21

519

COELIAC DISEASE

Adults with Down’s syndrome are at a higher risk of developing coeliac disease than the general population. Coeliac disease arises as a result of an allergic autoimmune reaction to gluten – a nitrogenous component of wheat, barley and rye. The lining of the small bowel becomes damaged, causing microscopic anatomical (histological) changes, including flattening of the intestinal villi. As a result, the small bowel becomes unable to absorb water and nutrients. Consequently, individuals with coeliac disease have regular loose bowel movements, which are bulky and foul smelling, and they have diminished appetite (anorexia) and weight loss. Impaired nutrition can affect hemoglobin, causing anemia, reduced bone density (osteoporosis) and alterations in intestinal bacterial population, leading to abdominal distension and contributing to irritable bowel syndrome (IBS).

The main way of diagnosing coeliac disease is through analyzing histological changes within a small tissue sample (biopsy) of the duodenum before and after a period of a gluten-free diet. Treatment involves totally removing gluten from the diet through avoiding all wheat, barley, oat and rye products. In many cases, relief of the symptoms is quickly appreciated – the older the sufferer, the longer the symptoms take to come under control. Coeliac disease is a long-standing (chronic) condition, although there are frequently periods of apparent total recovery (remission), during which time adherence to the dietary regime, which should include vitamin and iron supplements, continues to be necessary.