Basically,to know further about what really celiac disease is, it is simply a gluten induced diet. There is an
allergic reaction that forms within the lining of the small intestine. Gluten is a family of protein, and the ones
that are dissolved by alcohol are in the form of gliadin. It is the sub component of gluten that causes reaction
in our immune system. There is an incomplete synthesis of intestinal enzyme that remains a large chains of
amino acid which enters the cells in the lining of the small intestine. The irregular ability of the cells to sift
through the longer chains of amino acids,thus,these longer chains can cause damage to the intestinal cells.

So,what is the etiology behind this disease? It is known that heredity plays an important role in acquiring
celiac disease. Also, after ingestion of gluten, changes occur in the intestinal mucosa villi. Intestinal mucosa
becomes damaged, and villi will atrophy which reduces the absorption surface of the small intestine and
affects the absorption of ingested nutrients.

Manifestation shows that patient will have distended abdomen; growth retardation with lack of fat deposits
and muscle wasting;there is also vitamin a, d, e, k deficiency;and bulky, foul-smelling, fatty stools. This symptoms
appear usually within 3-6 months introduction of gluten.

The only helpful intervention that is not pharmacologic, of this disease is a strict gluten-free diet. Caregivers
are oblige to assess the growth of patient and must administer fluids for hydration. Also, monitor the intake
of hydration and the output through voiding, assess the elasticity of your skin, mucous membranes and urine
specific gravity. If this initial interventions are not strictly followed, complication can occur such as refractory
celiac disease. It is the disintegration of villi in the small intestine and eventual loss, which is considered to be
a malignant condition, that is, is a cancer.