Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about celiac disease. If you want to follow along with written notes on this topic,

you can follow along at zero definals.com slash celiac or in the gastroenterology section of the

zero to finals medicine book.

So let's get straight into it.

Celiac disease is an autoimmune condition where exposure to gluten causes an immune reaction that causes inflammation in the small bowel.

It usually develops in early childhood, but it can come on at any age.

In celiac disease, auto-antibodies, so antibodies against the body's own tissues,

are created in response to exposure to gluten, and the auto-antibodies target the epithelial

cells of the intestine and cause inflammation in these areas.

There's two auto-antibodies that you need to remember.

Anti-tissue Transglutaminase, which is anti-TTG, and the second one is anti-endemesial antibodies, which is anti-EMA.

And these antibodies also relate to disease activity, so they'll

rise and fall depending on how active the disease is, and they may disappear when there's

effective treatment. The inflammation affects a small bowel, particularly an area called the

jejunum, which is just after the duodenum, and it causes

atrophy of the intestinal villi. And these intestinal villi are found on intestinal epithelial

cells, and they're really important for absorbing nutrients from the food that's passing through

the intestine. So inflammation of these areas causes malabsorption of nutrients and the symptoms of the disease.

How do patients with celiac disease present? Well, they often are asymptomatic, so you need to have a low

threshold for testing for celiac disease in patients where it may be suspected. Some common presenting

features are failure to thrive in young children,

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