The folds of the duodenum are relatively sharp, but in the above pictures they are blunted and there is evidence of some inflammation on one hand and healing process on the other. If biopsies are not taken from beyond the usual extent of the upper GI endoscopy, the diagnosis may be missed.Celiac Disease is a commonly missed diagnosis. It is a disease that affects the ability of the small intestine to absorb nutrients.
Many times the patients experience vague discomfort around the navel and feel gasy. Diarrhea and nutritional deficiencies can occur. Anemia is another presentation. Some patients are labeled as irritable bowel syndrome (IBS) and are treated for a long time before the correct diagnosis is made. The underlying problem is stimulation of autoimmune system that hurts the lining of the small bowel. It is triggered by gliadin which is in abundance in wheat products. Some other legumes also contain gliadin.DIAGNOSIS:
Antibody testing in the blood is not reliable. The key to the diangosis is biopsy of the duodenum or jejunum. The cells of these parts of small bowel have finger-like extensions of their surface soaked in the nurtrients to be efficient in absorbing them. These finger-like extensions are called villi. In cases of celiac disease, the biopsies show blunting of the villi.MANAGEMENT:
The correct diagnosis is the most important part. Once the diagnosis is made, usually a proper diet can be prescribed and the disease can go into remission. However, if the disease is not properly treated, there could be serious consequences. The main treatment is to withdraw gliadin-containing food products from the diet. Occasonally some medicines have to be given. This disease has genetic basis for it and is seen more commonly in the family members of the patient with this diseae.