Celiac disease
1978
Lakness, Jean
Celiac disease, associated with combined symptoms of protruding abdomen, diarrhea, uncharacteristic stools, and other features, is caused by the patient's inability to detoxify gliadin, an intestinal mucosa-damaging metabolite of the common grain protein, gluten. As a result of mucosal damage of the small intestine, many nutrients are not absorbed, water/electrolytes are secreted into the intestinal lumen rather than absorbed by it, and fats and fat-soluble vitamins A, D, E, and K are not absorbed. A detailed gluten-free diet, covering types and amounts of foods to include and avoid, is elaborated. Since dietary management is based on removal of all gluten from the diet, the diet should exclude wheat, rye, barley, oats, and their products (e.g., malt). With initial treatment, the diet should be high in all nutrients and energy, especially iron, folic acid, calcium, magnesium, and vitamins A, D, E, and K. With return of appetite and normal bowel function, nutritional supplements may be gradually decreased. (wz)
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