Gluten and dyspepsia
نویسنده
چکیده
1 Celiac disease (CD) affects approximately 1% of the population. It is a disease that causes flattening of the epithelial lining of the small bowel and is characterized by (sub) total villous atrophy. The histological alterations in CD are graded according to the modified Marsh Classification from Marsch 0 (normal mucosa) to Marsch IIIc (total villous atrophy). Common symptoms include, but are not restricted to, malasborption, diarrhoea, malnutrition, failure to thrive in children and abdominal pain. Some patients with CD have no gastrointestinal symptoms or are asymptomatic (1). CD is caused by intolerance to gluten and a strict gluten free diet is the only available treatment. In the lamina propria of the small intestine of patients with CD there are T cells that respond to gluten fragments bound to the disease predisposing HLA-DQ2 and/or HLA-DQ8 molecules and secrete proinflammatory cytokines. The diagnosis of CD is based on the combination of HLA typing for DQ2 and DQ8, serum determination of specific CD antibodies (IgA anti-transglutaminase (tTG) and IgA antiendomisium (EMA) antibodies), on the results of small bowel biopsies and on the improvement of the symptoms after adherence to a gluten free diet (1-3). In this number of GHFBB, Rostami Nejad and co-authors report on the prevalence of CD in
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