Dr. John Chovan, PhD., DNP, RN, CNP, CNS
Celiac Disease, Gluten Intolerance, Wheat Allergy, Autoimmune Disorder
Medicine and Health Sciences | Nursing
Celiac disease (CD) affects approximately 3 million Americans and approximately 1% of people worldwide (Cui, Basen, Philipp, Yusin, & Krishnaswamy, 2017). Of the estimated 3 million American’s living with CD, approximately 97% of them are undiagnosed or suffering from symptoms and not receiving proper treatment (The University of Chicago Celiac Disease Center, n.d.). My father-in-law fell into this un-diagnosed category, having had CD and suffering from symptoms for over a year prior to diagnosis. Due to the genetic predisposition for developing this disease, I was interested in further researching this topic as my fiancé and daughter are at a 4%-17% increased risk of also developing CD later in life (Cui et al., 2017). The pathogenesis of CD is dependent on being genetically predisposed to the disease as well as being exposed to gluten and other environmental factors (Green, Lebwohl, & Greywoode, 2015). In individuals with CD, partially digested gluten proteins enter the epithelial barrier of the small intestinal mucosa, triggering innate and adaptive immune responses (Lebwohl, Ludvigsson & Green, 2015). These immune responses produce the classic gastrointestinal (GI) symptoms of diarrhea, abdominal pain/distension and malnutrition, as well atypical extra-intestinal symptoms such as iron deficiency anemia (Robinson, Davis, Vess, & Lebel, 2015). Diagnosis of the disease includes serologic testing and duodenal biopsy via upper endoscopy in order to assess the extent of villous atrophy noted (Cui et al., 2017). Treatment requires strict adherence to a gluten free diet, as well as routine testing and follow-up to assess that the intestinal mucosa is healing properly (Cui et al., 2017).
Vigil, Alexandria, "Pathophysiology of Celiac Disease" (2018). Master of Science in Nursing (MSN) Student Scholarship. 308.