Lesson Plan
on
Celiac Disease
Ms. K. Lavanya
M.Sc (N)- CHN
Associate Professor

Objective Time Content Teachers
Activity
Students
Activity
A.V.
Aids
Evalua
tion
Definition:
Celiac disease also known as gluten induced enteropathy, gluten
sensitive enteropathy and celiac sprue.
It is a disease of the proximal small intestine characterized by abnormal
mucosa and permanent intolerance to gluten.
Incidence:
More frequent in Europeans than in Americans and is rarely reported in
Asians or blacks.
Previously it was 1 in 6000 individuals, recently it was 1 in 250
individuals.
Etiology:
 Idiopathic
 Mutation of Genes
 Absence of the healthy bacteria which helps in the
digestion process.
 Gluten- Consuming gluten triggers the abnormal immune
system response that causes celiac disease

Pathophysiology:
Clinical Manifestations:
Impaired Fat absorption
 Steatorrhea (excessively large, pale, oily, frothly stools)
 Exceedingly foul-smelling stools.
Impaired Absorption of Nutrients
 Malnutrition
 Muscle wasting (especially prominent in legs & buttocks)
 Anemia
 Anorexia
 Abdominal Distention

Behavioral Changes
 Irritability
 Fretfulness
 Uncooperativeness
 Apathy
Celiac Crisis
 Acute, severe episodes of profuse watery diarrhea and vomiting
May be precipitated by:
 Infections (specially gastrointestinal)
 Prolonged fluid and electrolyte depletion
 Emotional disturbance
For Adults:
 Diarrhea
 Fatigue
 Weight loss
 Bloating and gas
 Abdominal pain
 Nausea and vomiting
 Constipation
Diagnostic Evaluation:
 HC
 PE
 Biopsy of the small intestine
 Mucosal Inflammation
 Crypt hyperplasia
 Villous atrophy
 Serologic test- to detect antibodies to connective tissue
(endomysium & reticulin) and to gliadin.

 Antigliadin, antireticulin, & antiendomysial IgG & IgA
antibodies- More specific markers for active celiac disease.
 Enzyme tissue transglutaminase (tTG),
Management:
 The diet should be gluten free
 Restriction on wheat, rye, barley & oats
 Correction of nutritional deficiencies with supplements
including vitamins, iron, & Calories
Complications:
 Lactose Intolerance
Bibliography:
 Wong’s. (2005), Essentials of Pediatric nursing, 7th Edition, Elsevier
Publications, New Delhi. Page no: 885- 886.