What is Celiac Disease?

Celiac disease (CD)is a serious autoimmune disease that occurs in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. It is characterized by the presence of chronic inflammation of the small bowel’s mucosa and submucosa.t is characterized by immune-mediated enteropathy, associated with maldigestion and malabsorption of most nutrients and vitamins. It is hereditary, meaning that it runs in families. People with a first-degree relative with celiac disease (parent, child, sibling) have a 1 in 10 risk of developing celiac disease. It may start at any age, both during childhood and adolescence, and is also relatively common in adulthood.CD is associated with increased rates of several diseases, such as iron deficiency anemia, osteoporosis, dermatitis herpetiformis, several neurologic and endocrine diseases, persistent chronic hypertransami-nasemia of unknown origin, various types of cancer and other autoimmune disorders. Treatment of CD dictates a strict, life-long gluten-free diet, which results in remission for most individuals, although its effect on some associated extraintestinal manifestations remains to be established.

Symptoms

The clinical presentation of CD varies greatly, ranging from asymptomatic to severely malnourished patients. 

  • abdominal cramping pain with moderate to severe abdominal distension
  • frequently associated with relapsing or permanent dyspepsia
  • presence of gastro-esophageal reflux (GERD) 
  • recurrent episodes of altered bowel habits (diarrhea and/or constipation)
  • weight loss
  • bone disease
  • anemia 
  • Weakness
  • abdominal distension after meals
  • bloating flatulence
  • lactose malabsorption
  • Edema
  • Bone or joint pain

Cause

  • Unknown but is thought to be primarily immune mediated (tissue-transglutaminase autoantigen)
  • Often the disease is inherited

Triggers

The triggers for CD are specific immunogenic peptides that are present only and exclusively in the dietary gluten proteins, from wheat and similar structural cereals such as rye and barley. These peptides are resistant to digestion by gastric and pancreatic enzymes and find their way into the lamina propria of the small bowel, presumably after some changes occur in the intercellular tight junctions with an increase in the intestinal permeability. 

Tests and Diagnosis

  • Serological screening tests
  • Endoscopic 
  • Jejunal biopsy

Treatment

  • Gluten-free diet (Strict lifelong adherence to a GFD, in which the patient must avoid permanently all kinds of food products containing some wheat, rye, barley and oat)
  • Immunotherapy
  • Administration of iron preparations 

Recipes

  1. Arugula & Canadian Bacon Egg White Omelet

Ingredients

  • 2 tablespoons Butter divided
  • 1 cup Arugula
  • 4 cherry tomatoes halved
  • 2 tablespoons Red Onions chopped
  • 3 Egg Whites
  • Salt & Pepper
  • 1 heaping tablespoon Basil fresh, sliced
  • 1 slice Jones Dairy Farm Canadian Bacon chopped

Preparation

  • Melt 1 tablespoon butter in 10-inch nonstick skillet over medium high heat.
  • Add arugula, tomatoes and onion and cook for 1 minute.
  • Remove from skillet and set aside. Wipe skillet clean.
  • Whisk egg whites with pinch of kosher salt and black pepper. Melt remaining butter in skillet over medium heat. Pour in eggs and cook for about 5 seconds. Lift cooked egg up around edges to allow uncooked egg to flow underneath, until omelet is set but top is still moist, about 2 to 3 minutes.
  • Arrange vegetables, basil and Canadian Bacon on one half of omelet and carefully fold over. Cook for an additional 1 to 2 minutes, or until heated through. Transfer omelet to plate and serve immediately.

  1. Baked Tomato Cups

Ingredients

  • 4 Medium Tomatoes
  • 1 Tablespoon Butter or oil
  • 4 Eggs
  • 2 Tablespoons Cream
  • 6 Jones Dairy Farm Golden Brown Breakfast Sausage Links sliced
  • 1 Cup Cheddar Cheese shredded
  • 2 Tablespoons Basil fresh

Preparation

  • Preheat oven to 350˚F. Slice tops and stems off tomatoes. Use knife to cut around inside of tomatoes and loosen ribs and seeds. Scoop out with spoon and discard.
  • Heat butter or oil in skillet over medium-low heat until melted. In medium bowl, whisk together eggs and cream until well combined. Season to taste.
  • Pour egg mixture into skillet and let sit 30 seconds without stirring. Then use spatula or wooden spoon to stir, lifting and folding from bottom. Continue until eggs are cooked through. Add sliced sausage to pan and stir. Add half of shredded cheese, stir to combine.
  • Fill each tomato with mixture and top each with remaining shredded cheese. Bake 10-20 minutes, until tomatoes are tender and cheese is melted and bubbly. Sprinkle with fresh basil and serve.

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