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Latest revision as of 20:50, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

Since the advent of human life on the earth, human beings have met their nutritional demands through hunting. In times of scarce supply of food from animal sources humans used to turn to fruits, seeds, and nuts for their nutritional needs. About 8,000 years ago, Aretaeus, a Greek physician from Cappadocia, wrote a total of 8 books on medicine. In one of his books, he described a patient with celiac disease and called it 'koiliakos'. It came from Greek word of 'koelia' (abdomen), explaining diarrhea as the inability to retain food and the passage of undigested material through the gastrointestinal tract. This later formed the basis of explanation of various diseases presenting as chronic malabsorptive diarrhea, including celiac disease. In October 1887, Samuel Gee, an English pediatrician, comprehensively explained celiac disease in one of his lectures. Gee was of the opinion that if a patient affected by celiac disease can be cured at all, it must be by means of diet. He also added that the percentage of farinaceous food intake in celiac patients must be low. Gee also introduced the concept of gluten-free diet for the relief of symptoms.

Historical Perspective

Here is the historical perspective of celiac disease at a glance

Beginning of the mankind

2.5 million years ago

Hunting and eating meat, fruits, seeds, and nuts

10,000 years ago

Neolithic period

Discovery of agriculture.
New antigens have been introduced to human diet
(protein from cow, goat, and donkey milk, bird eggs, and various cereals).
First cases of celiac disease.

Discovery

2,000 years ago

Aretaeus
A Cappadocian physician

Described celiac disease, calling it koiliakos.
It came from Greek word 'koelia (abdomen), representing a "suffering abdomen"

1812

Mathew Baillie
A Scottish physician

Described some adult patients experiencing malnutrition and bloating along with chronic diarrhea

1887

Samuel Gee
A famous English pediatrician

Gave a detailed explanation of celiac disease, presenting a lecture on "Celiac affection"

1924

Sidney Haas
A New York city pediatrician

Used a new dietetic therapeutic option for 10 children with celiac disease, the banana diet

1949

Wood
An Australian gastroenterologist

Invented a simple flexible biopsy tube which could be used for GI biopsies without requiring X-ray or gastroscope assistance

1950

Wim Dicke
A Dutch pediatrician

Suggested in his doctoral thesis that elimination of wheat, rye, and oats from diet would result in cure of celiac disease

1950

Wim Dicke's colleagues,
Weijers and Van de Kamer

Presented stool fat measurement as a method to diagnose celiac disease

1954

John Paulley
An English pathologist from Ipswich

Discovered the pathophysiology of celiac disease, that is histological abnormalities in small intestine lining

Diagnosis

1955

Marcelo Royer
An Argentinian gastroenterologist from Buenos Aires

Developed a technique for duodenal biopsy under fluoroscopic vision

1956

Margot Shiner
A German-British gastroenterologist

Developed another technique for duodenal biopsy under fluoroscopic vision

1964

Berger
A Switzerland immunologist

Detected and reported anti gliadin antibodies in children with celiac disease

1969

European Society of Pediatric Gastroenterology
(now ESPGHAN)

Gave the diagnostic tool of “Interlaken criteria”, which was used for about 20 years

1971

Seah
A British physician

Discovered an auto-antibody, the anti-reticulin; showing that antibody is not necessarily an anti-food protein

1983

Chorzelski
A Polish dermatologist from Warsaw

Discovered anti-endomysium antibodies and dermatitis herpetiformis in celiac disease patients

Treatment

Recently

Main guidelines

• Agency for Healthcare Research and Quality (AHRQ, 2004)^[1]
• American Gastroenterological Association (AGA, 2006)^[2]
• North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NSPGHAN, 2005)^[3]
• European Society of Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN, 2012)^[4]
• National Institute for Health and Clinical Excellence (NICE, 2015)^[5]

Discovery

At the beginning of human life on the earth, nutritional demands were met through hunting. In severe circumstances, inability to hunt for a while, encouraged the utilization of fruits, seeds, and nuts.^[6]
10,000 years ago the mankind learnt to cultivate and grow agriculture. Humans have utilized foods that were not been known for 2.5 million years.^[7]
During Neolithic period, some new foods such as milk from cow, goat, and donkey, along with bird eggs, and various cereals were introduced for daily utilization of human beings.^[6]
Amongst agricultural products, wheat showed a higher rate of growth and resistance to environmental changes. It became the main food source of human beings related to agriculture.^[8]
There were no problems until some members of the tribe suffered from abdominal discomfort, after eating wheat based products.
About 2,000 years ago, Aretaeus, a physician from Cappadocia, wrote a total of 8 books on medicine. In one of his books, he described a patient with celiac disease and named it 'koiliakos', derived from a Greek word 'koelia' (abdomen). This was represented as “if the stomach be irretentive of the food and if it pass through undigested and crude, and nothing ascends into the body, we call such persons coeliacs”.^[6]
17 centuries later, in 1812, Mathew Baillie, a Scottish physician, probably unaware of Aretaeus, presented his point of view about some adult patients experiencing malnutrition and bloated abdomen along with chronic diarrhea due to specific diet, “some patients have appeared to derive considerable advantage from living almost entirely upon rice." Unfortunately, his work was not considered much.^[6]
In October 1887, Samuel Gee, an English leading authority in pediatrics, gained the full credit of explanation of celiac disease, presenting a lecture named "celiac affection" to medical students; which was published next year. Gee mentioned that "If the patient can be cured at all, it must be by means of diet".^[9] He also added that "the allowance of farinaceous food must be small".^[10] He also found gluten-free diet relieved symptoms, which relapsed when gluten was introduced again.^[6]
In 1920s, Sidney Haas, a New York city pediatrician, used a new dietetic therapeutic option for 10 children with celiac disease, the banana diet; owing to his success in treating a child with anorexia nervosa by the diet. 8 of those children were "clinically cured" and the remaining 2 died.^[11]
In 1949, Wood, an Australian gastroenterologist, invented a simple flexible biopsy tube which could be used for GI biopsies without requiring X-ray or gastroscope.^[12]
In 1950, Wim Dicke, a Dutch pediatrician, suggested in his doctoral thesis that elimination of wheat, rye, and oats from diet would result in reasonable cure of celiac disease. He found the pathological factor to be gluten.^[13]
At the same time, Wim Dicke's colleagues, Weijers and Van de Kamer, presented a way to diagnose celiac disease by using stool fat measurement.^[14]
In 1954, John Paulley, a pathologist from Ipswich in England, discovered the histological abnormalities in small intestinal lining as the main pathophysiology of celiac disease.^[15]

Diagnosis

In 1955, Marcelo Royer, a gastroenterologist from Buenos Aires, developed a technique for duodenal biopsy under fluoroscopic vision. He was inspired by Wood's instrument.^[16]
In 1956, Margot Shiner, a German-British gastroenterologist, also developed a technique for duodenal biopsy under fluoroscopic vision. He was also inspired by Wood's instrument.^[17]
In the mid to late 60’s, it was understood that a jejunal biopsy, showing villus atrophy was the best way to diagnose celiac disease. Since atrophy of villi may also have some other causes, the diagnosis could not be approved until gluten was proven to be the cause of atrophy.
In 1964, Berger, a Switzerland immunologist, detected and reported anti-gliadin antibodies in children with celiac disease.^[18]
In 1969, European Society of Pediatric Gastroenterology (now ESPGHAN), presented “Interlaken criteria” as a diagnostic tool, which was used for about 20 years. The criteria consisted of full remission of the symptoms on using gluten-free diet, along with curing the atrophic lesions in GI lumen, and finally recurrence of the disease, once gluten was reintroduced in diet.^[6]
In 1971, Seah, a British doctor, found that the antibody is not necessarily an anti-food protein, but it is actually an auto-antibody, the anti-reticulin.^[19]
In 1983, Chorzelski, a dermatologist from Warsaw, discovered anti-endomysium antibodies and dermatitis herpetiformis in celiac disease.^[20]
In 1986, the Coeliac society on United Kingdom was founded. Similar societies were also founded around the world.

Treatment

The main management guidelines are issued by Agency for Healthcare Research and Quality (AHRQ, 2004)^[1], the American Gastroenterological Association (AGA, 2006)^[2], the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NSPGHAN, 2005)^[3], the European Society of Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN, 2012)^[4], and National Institute for Health and Clinical Excellence (NICE, 2015)^[5].

Outbreaks

There has just been one outbreak of celiac disease in Sweden. The details of this outbreak are summarized below:^[21]
- It was established that since celiac disease has genetic, immune-mediated, and chronic features, it rarely contributes to an outbreak.
- This outbreak was quite unique for celiac disease, suggesting evolution of causal factors or environmental influences on Swedish children.
- It is assumed that an outbreak can be caused by introducing large amounts of gluten containing foods to the diet of children, immediately after withholding breast milk.
- At the beginning of outbreak more girls were affected with celiac disease than boys.
- Children that were born in summer had higher rate of celiac disease, due to high gluten containing foods during winter, when the infections are more common.

Landmark Events in the Development of Treatment Strategies

In October 1887, Samuel Gee, an English leading authority in pediatrics, completely explained celiac disease, presenting a lecture named "celiac affection" to medical students; which was published the year later. Gee mentioned that "If the patient can be cured at all, it must be by means of diet".^[9] He also added that "the allowance of farinaceous food must be small".^[10] He also found that the gluten-free diet relieved symptoms, which relapsed when gluten was reintroduced.^[6]

Famous Cases

The following are a few famous cases of celiac disease:
- Drew Brees: Star quarterback for the Saints
- Justin Morneau: Twins first baseman Justin Morneau
- Chelsea Clinton: Bill Clinton’s daughter
- Zooey Deschanel: Star of the show “New Girl”
- Novak Djokovic: World renowned tennis player
- Victoria Beckham: Wife of soccer star, David Beckham
- Jessica Simpson: Actress
- Amy Yoder Begley: Olympic runner
- Ryan Phillippe: MacGruber star
- Susie Essman: Mostly known for her role on the show “Curb Your Enthusiasm”
- Rachel Weisz: Appeared in films such as “Constantine” and “The Mummy”
- Heidi Collins: A news anchor for CNN
- Robin McGraw: Dr. Phil’s wife
- Keith Olbermann: A broadcaster for Fox and ESPN
- Cedric Benson: Cincinnati Bengals running back
- Josh Turner: Famed country singer
- Elisabeth Hasselbeck: Member of “The View”
- Emmy Rossum: Known for her glamorous acting
- Dana Vollmer: U.S. swimmer
- James Starks: Green Bay Packers running back

References

↑ ^1.0 ^1.1 "Celiac Disease: Summary - AHRQ Evidence Report Summaries - NCBI Bookshelf".
↑ ^2.0 ^2.1 Rostom A, Murray JA, Kagnoff MF (2006). "American Gastroenterological Association (AGA) Institute technical review on the diagnosis and management of celiac disease". Gastroenterology. 131 (6): 1981–2002. doi:10.1053/j.gastro.2006.10.004. PMID 17087937.
↑ ^3.0 ^3.1 Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, Hoffenberg EJ, Horvath K, Murray JA, Pivor M, Seidman EG (2005). "Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition". J. Pediatr. Gastroenterol. Nutr. 40 (1): 1–19. PMID 15625418.
↑ ^4.0 ^4.1 Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, Troncone R, Giersiepen K, Branski D, Catassi C, Lelgeman M, Mäki M, Ribes-Koninckx C, Ventura A, Zimmer KP (2012). "European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease". J. Pediatr. Gastroenterol. Nutr. 54 (1): 136–60. doi:10.1097/MPG.0b013e31821a23d0. PMID 22197856.
↑ ^5.0 ^5.1 "Coeliac disease: recognition, assessment and management | Guidance and guidelines | NICE".
↑ ^6.0 ^6.1 ^6.2 ^6.3 ^6.4 ^6.5 ^6.6 "www.cureceliacdisease.org" (PDF).
↑ Guandalini, Stefano (2008). "Historical Perspective of Celiac Disease": 1–11. doi:10.1159/000128267.
↑ Guandalini, Stefano (2008). "Historical Perspective of Celiac Disease": 1–11. doi:10.1159/000128267.
↑ ^9.0 ^9.1 Dowd B, Walker-Smith J (1974). "Samuel Gee, Aretaeus, and the coeliac affection". Br Med J. 2 (5909): 45–7. PMC 1610148. PMID 4595183.
↑ ^10.0 ^10.1 Losowsky MS (2008). "A history of coeliac disease". Dig Dis. 26 (2): 112–20. doi:10.1159/000116768. PMID 18431060.
↑ Haas, Sidney V. (1932). "CELIAC DISEASE". Journal of the American Medical Association. 99 (6): 448. doi:10.1001/jama.1932.02740580016004. ISSN 0002-9955.
↑ Wood, I (1949). "GASTRIC BIOPSY REPORT ON FIFTY-FIVE BIOPSIES USING A NEW FLEXIBLE GASTRIC BIOPSY TUBE". The Lancet. 253 (6540): 18–21. doi:10.1016/S0140-6736(49)90344-X. ISSN 0140-6736.
↑ Dicke, W. K.; Weijers, H. A.; KAMER, J. H. v. D. (1953). "Coeliac Disease The Presence in Wheat of a Factor Having a Deleterious Effect in Cases of Coeliac Disease". Acta Paediatrica. 42 (1): 34–42. doi:10.1111/j.1651-2227.1953.tb05563.x. ISSN 0803-5253.
↑ Kamer, J. H. Van De; Weijers, H. A.; Dicke, W. K. (1953). "Coeliac Disease: An Investigation into the Injurious Constituents of Wheat in Connection with their Action on Patients with Coeliac Disease". Acta Paediatrica. 42 (3): 223–231. doi:10.1111/j.1651-2227.1953.tb05586.x. ISSN 0803-5253.
↑ Paulley, J. W. (1954). "Observations on the Aetiology of Idiopathic Steatorrhoea". BMJ. 2 (4900): 1318–1321. doi:10.1136/bmj.2.4900.1318. ISSN 0959-8138.
↑ ROYER M, CROXATTO O, BIEMPICA L, BALCAZAR MORRISON AJ (1955). "[Duodenal biopsy by aspiration under radioscopic control]". Prensa Med Argent (in Spanish; Castilian). 42 (33): 2515–9. PMID 13289533.
↑ Shiner, Margot (1956). "DUODENAL BIOPSY". The Lancet. 267 (6906): 17–19. doi:10.1016/S0140-6736(56)91854-2. ISSN 0140-6736.
↑ "Diagnostische Bewertung des Nachweises von Gliadin-Antikörpern bei Cöliakie | SpringerLink".
↑ Seah PP, Fry L, Hoffbrand AV, Holborow EJ (1971). "Tissue antibodies in dermatitis herpetiformis and adult coeliac disease". Lancet. 1 (7704): 834–6. PMID 4102529.
↑ Chorzelski, T.P.; Beutner, E.H.; Sulej, J.; Tchorzewska, H.; Jablonska, S.; Kumar, V.; Kapuscinska, A. (1984). "IgA anti-endomysium antibody. A new immunological marker of dermatitis herpetiformis and coeliac disease". British Journal of Dermatology. 111 (4): 395–402. doi:10.1111/j.1365-2133.1984.tb06601.x. ISSN 0007-0963.
↑ Ivarsson A (2005). "The Swedish epidemic of coeliac disease explored using an epidemiological approach--some lessons to be learnt". Best Pract Res Clin Gastroenterol. 19 (3): 425–40. doi:10.1016/j.bpg.2005.02.005. PMID 15925847.

Template:WH Template:WS

[urlCeliac_Disease:_Summary_-_AHRQ_Evidence_Report_Summaries_-_NCBI_Bookshelf-1] 1.0 ^1.1 "Celiac Disease: Summary - AHRQ Evidence Report Summaries - NCBI Bookshelf".

[pmid17087937-2] 2.0 ^2.1 Rostom A, Murray JA, Kagnoff MF (2006). "American Gastroenterological Association (AGA) Institute technical review on the diagnosis and management of celiac disease". Gastroenterology. 131 (6): 1981–2002. doi:10.1053/j.gastro.2006.10.004. PMID 17087937.

[pmid15625418-3] 3.0 ^3.1 Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, Hoffenberg EJ, Horvath K, Murray JA, Pivor M, Seidman EG (2005). "Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition". J. Pediatr. Gastroenterol. Nutr. 40 (1): 1–19. PMID 15625418.

[pmid22197856-4] 4.0 ^4.1 Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, Troncone R, Giersiepen K, Branski D, Catassi C, Lelgeman M, Mäki M, Ribes-Koninckx C, Ventura A, Zimmer KP (2012). "European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease". J. Pediatr. Gastroenterol. Nutr. 54 (1): 136–60. doi:10.1097/MPG.0b013e31821a23d0. PMID 22197856.

[urlCoeliac_disease:_recognition,_assessment_and_management_|_Guidance_and_guidelines_|_NICE-5] 5.0 ^5.1 "Coeliac disease: recognition, assessment and management | Guidance and guidelines | NICE".

[urlwww.cureceliacdisease.org2-6] 6.0 ^6.1 ^6.2 ^6.3 ^6.4 ^6.5 ^6.6 "www.cureceliacdisease.org" (PDF).

[Guandalini20082-7] Guandalini, Stefano (2008). "Historical Perspective of Celiac Disease": 1–11. doi:10.1159/000128267.

[Guandalini20083-8] Guandalini, Stefano (2008). "Historical Perspective of Celiac Disease": 1–11. doi:10.1159/000128267.

[pmid4595183-9] 9.0 ^9.1 Dowd B, Walker-Smith J (1974). "Samuel Gee, Aretaeus, and the coeliac affection". Br Med J. 2 (5909): 45–7. PMC 1610148. PMID 4595183.

[pmid18431060-10] 10.0 ^10.1 Losowsky MS (2008). "A history of coeliac disease". Dig Dis. 26 (2): 112–20. doi:10.1159/000116768. PMID 18431060.

[Haas1932-11] Haas, Sidney V. (1932). "CELIAC DISEASE". Journal of the American Medical Association. 99 (6): 448. doi:10.1001/jama.1932.02740580016004. ISSN 0002-9955.

[Wood1949-12] Wood, I (1949). "GASTRIC BIOPSY REPORT ON FIFTY-FIVE BIOPSIES USING A NEW FLEXIBLE GASTRIC BIOPSY TUBE". The Lancet. 253 (6540): 18–21. doi:10.1016/S0140-6736(49)90344-X. ISSN 0140-6736.

[DickeWeijers1953-13] Dicke, W. K.; Weijers, H. A.; KAMER, J. H. v. D. (1953). "Coeliac Disease The Presence in Wheat of a Factor Having a Deleterious Effect in Cases of Coeliac Disease". Acta Paediatrica. 42 (1): 34–42. doi:10.1111/j.1651-2227.1953.tb05563.x. ISSN 0803-5253.

[KamerWeijers1953-14] Kamer, J. H. Van De; Weijers, H. A.; Dicke, W. K. (1953). "Coeliac Disease: An Investigation into the Injurious Constituents of Wheat in Connection with their Action on Patients with Coeliac Disease". Acta Paediatrica. 42 (3): 223–231. doi:10.1111/j.1651-2227.1953.tb05586.x. ISSN 0803-5253.

[Paulley1954-15] Paulley, J. W. (1954). "Observations on the Aetiology of Idiopathic Steatorrhoea". BMJ. 2 (4900): 1318–1321. doi:10.1136/bmj.2.4900.1318. ISSN 0959-8138.

[pmid13289533-16] ROYER M, CROXATTO O, BIEMPICA L, BALCAZAR MORRISON AJ (1955). "[Duodenal biopsy by aspiration under radioscopic control]". Prensa Med Argent (in Spanish; Castilian). 42 (33): 2515–9. PMID 13289533.

[Shiner1956-17] Shiner, Margot (1956). "DUODENAL BIOPSY". The Lancet. 267 (6906): 17–19. doi:10.1016/S0140-6736(56)91854-2. ISSN 0140-6736.

[urlDiagnostische_Bewertung_des_Nachweises_von_Gliadin-Antikörpern_bei_Cöliakie_|_SpringerLink-18] "Diagnostische Bewertung des Nachweises von Gliadin-Antikörpern bei Cöliakie | SpringerLink".

[pmid4102529-19] Seah PP, Fry L, Hoffbrand AV, Holborow EJ (1971). "Tissue antibodies in dermatitis herpetiformis and adult coeliac disease". Lancet. 1 (7704): 834–6. PMID 4102529.

[ChorzelskiBeutner1984-20] Chorzelski, T.P.; Beutner, E.H.; Sulej, J.; Tchorzewska, H.; Jablonska, S.; Kumar, V.; Kapuscinska, A. (1984). "IgA anti-endomysium antibody. A new immunological marker of dermatitis herpetiformis and coeliac disease". British Journal of Dermatology. 111 (4): 395–402. doi:10.1111/j.1365-2133.1984.tb06601.x. ISSN 0007-0963.

[pmid15925847-21] Ivarsson A (2005). "The Swedish epidemic of coeliac disease explored using an epidemiological approach--some lessons to be learnt". Best Pract Res Clin Gastroenterol. 19 (3): 425–40. doi:10.1016/j.bpg.2005.02.005. PMID 15925847.

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@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Celiac disease}}
-{{CMG}}; {{AE}}
+{{CMG}}; {{AE}}{{EG}}
 ==Overview==
-From beginning of [[human being]] life on the earth, he met his [[nutritional]] demands through hunting. Whenever the conditions became severe and there were not any hunting for a while, inevitably, he came to fruits, seeds, and nuts. About 8,000 years ago, Aretaeus, a clever Greek physician from Cappadocia, has written total of 8 books about different topics of [[medicine]]. In one of his books, he completely describe a patient with Celiac disease, called it '<nowiki/>'''''koiliakos'''''<nowiki/>'. It came from Greek word of ''''''koelia'''''<nowiki/>' ([[abdomen]]), represent as “if the [[stomach]] be irretentive of the food and if it pass through undigested and crude, and nothing ascends into the body, we call such persons coeliacs”. There have been just one [[outbreak]] of Celiac disease in Sweden, 2005. In October 1887, Samuel Gee, an English leading authority in [[pediatrics]], has gain the full credit of explanation of Celiac disease, presenting "Celiac affection" lecture to medical students; which is published next year. Gee mentioned that "If the patient can be cured at all, it must be by means of [[diet]]". He also added that "the allowance of farinaceous food must be small". He also found the [[gluten-free diet]] as a relief, the symptoms relapse when [[gluten]] introduced again.
+Since the advent of human life on the earth, human beings have met their [[nutritional]] demands through hunting. In times of scarce supply of food from animal sources humans used to turn to fruits, seeds, and nuts for their nutritional needs. About 8,000 years ago, Aretaeus, a Greek physician from Cappadocia, wrote a total of 8 books on [[medicine]]. In one of his books, he described a patient with celiac disease and called it '<nowiki/>'''''koiliakos'''''<nowiki/>'. It came from Greek word of ''''''koelia'''''<nowiki/>' ([[abdomen]]), explaining diarrhea as the inability to retain  food and the passage of undigested material through the gastrointestinal tract. This later formed the basis of explanation of various diseases presenting as chronic malabsorptive diarrhea, including celiac disease. In October 1887, Samuel Gee, an English pediatrician, comprehensively explained celiac disease in one of his lectures. Gee was of the opinion that if a patient affected by celiac disease can be cured at all, it must be by means of [[diet]]. He also added that the percentage of farinaceous food intake in celiac patients must be low. Gee also introduced the concept of [[gluten-free diet]] for the relief of symptoms.
 ==Historical Perspective==
-'''Here is the historical perspective of Celiac disease at a glance'''
+'''Here is the historical perspective of celiac disease at a glance'''
 {{Family tree/start}}
-{{Family tree | | | | | | C01 |-| C02 |-| C03 | |C01= '''From beginning the human beings life'''|C02= '''''2.5 million years ago'''''|C03= Hunting and eating meat, fruits, seeds, and nuts}}
+{{Family tree | | | | | | C01 |-| C02 |-| C03 | |C01= '''Beginning of the mankind'''|C02= '''''2.5 million years ago'''''|C03= Hunting and eating meat, fruits, seeds, and nuts}}
 {{Family tree | | | | | | |:| | | | | | | | | | | }}
 {{Family tree | | | | | | |:| | | | | | | | | | | }}
-{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01= '''10,000 years ago'''|G02= '''''Neolithic period'''''|G03= Agriculture been discovered. <br>New sorts of [[antigens]] have produced to [[human beings]] daily regimen, such as cow, goat, and donkey milks' [[proteins]], along with various birds' eggs, and also different cereals.<br> Celiac disease involved the people for the first time. }}
 {{Family tree | | | | | | |:| | | | | | | | | | | }}
-{{Family tree | | A01 |-| B01 |-| B02 |-| B03 | |A01= '''Discovery'''|B01= '''2,000 years ago'''|B02= '''''Aretaeus, a clever Greek physician from Cappadocia'''''|B03=Described Celiac disease, called it '''''koiliakos'''''.<br> It came from Greek word of ''''''koelia''''' ([[abdomen]]), means "suffered abdomen"}}
+{{Family tree | | | | | | |:| | | | | | | | | | | }}
+{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01= '''10,000 years ago'''|G02= '''''Neolithic period'''''|G03= Discovery of agriculture. <br>New [[antigens]] have been introduced to human diet<br> (protein from cow, goat, and donkey milk, bird eggs, and various cereals).<br> First cases of celiac disease. }}
+{{Family tree | | | | | | |:| | | | | | | | | | | }}
+{{Family tree | | A01 |-| B01 |-| B02 |-| B03 | |A01= '''Discovery'''|B01= '''2,000 years ago'''|B02= '''''Aretaeus'''''<br>A Cappadocian physician|B03=Described celiac disease, calling it '''''koiliakos'''''.<br> It came from Greek word ''''''koelia''''' ([[abdomen]]), representing a "suffering abdomen"}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | | | | | C01 |-| C02 |-| C03 | |C01= '''1812'''|C02= '''''Mathew Baillie, an Scottish physician'''''|C03=Described some adult patients experiencing [[malnutrition]] and [[bloating]] [[abdomen]] along with [[chronic diarrhea]] due to specific regimen}}
+{{Family tree | | | | | | C01 |-| C02 |-| C03 | |C01= '''1812'''|C02= '''''Mathew Baillie'''''<br>A Scottish physician|C03=Described some adult patients experiencing [[malnutrition]] and [[bloating]] along with [[chronic diarrhea]] }}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01= '''1887'''|G02= '''''Samuel Gee, an English leading authority in pediatrics'''''|G03= Gained the full credit of explanation of Celiac disease, presenting "Celiac affection" lecture}}
+{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01= '''1887'''|G02= '''''Samuel Gee'''''<br>A famous English [[pediatrician]]|G03= Gave a detailed explanation of celiac disease, presenting a lecture on "Celiac affection"}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | | | | | E01 |-| E02 |-| E03 | |E01= '''1924'''|E02= '''''Sidney Haas, a New York city [[pediatrician]]'''''|E03= Used a new [[Dietetics|dietetic]] therapeutic option for 10 children with Celiac disease, '''''the banana diet'''''}}
+{{Family tree | | | | | | E01 |-| E02 |-| E03 | |E01= '''1924'''|E02= '''''Sidney Haas'''''<br>A New York city [[pediatrician]]|E03= Used a new [[Dietetics|dietetic]] therapeutic option for 10 children with celiac disease, '''''the banana diet'''''}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01= '''1949'''|G02= '''''Wood, an Australian [[gastroenterologist]]'''''|G03= Invented a simple flexible biopsy tube which can be used for GI biopsies without need to [[X-ray]] or [[gastroscope]]}}
+{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01= '''1949'''|G02= '''''Wood'''''<br>An Australian [[gastroenterologist]]|G03= Invented a simple flexible biopsy tube which could be used for GI biopsies without requiring [[X-ray]] or [[gastroscope]] assistance}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | | | | | D01 |-| D02 |-| D03 | |D01= '''1950'''|D02= '''''Wim Dicke, a Dutch [[pediatrician]]'''''|D03= Suggested in his doctoral thesis that elimination of [[wheat]], rye, and [[Oat|oats]] from diet would be result in reasonable cure}}
+{{Family tree | | | | | | D01 |-| D02 |-| D03 | |D01= '''1950'''|D02= '''''Wim Dicke'''''<br>A Dutch [[pediatrician]]|D03= Suggested in his doctoral thesis that elimination of [[wheat]], rye, and [[Oat|oats]] from diet would result in cure of celiac disease}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01= '''1950'''|G02= ''''' Wim Dicke's colleagues, Weijers and Van de Kamer'''''|G03= Presented [[stool]] [[fat]] measurement as a way to diagnosis of the Celiac disease}}
+{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01= '''1950'''|G02= ''''' Wim Dicke's colleagues,<br> Weijers and Van de Kamer'''''|G03= Presented [[stool]] [[fat]] measurement as a method to diagnose celiac disease}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | | | | | F01 |-| F02 |-| F03 | |F01= '''1954'''|F02= ''''' John Paulley, a [[pathologist]] from Ipswich in England'''''|F03= Discovered the main [[pathophysiology]] of Celiac disease, the [[histological]] abnormalities in [[small intestine]] lining}}
+{{Family tree | | | | | | F01 |-| F02 |-| F03 | |F01= '''1954'''|F02= ''''' John Paulley'''''<br>An English [[pathologist]] from Ipswich |F03= Discovered the [[pathophysiology]] of celiac disease, that is [[histological]] abnormalities in [[small intestine]] lining}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | A01 |-| G01 |-| G02 |-| G03 | |A01='''Diagnosis'''|G01= '''1955'''|G02= ''''' Marcelo Royer, a [[gastroenterologist]] from Buenos Aires'''''|G03= Developed a reliable technique for [[duodenal]] [[biopsy]] under [[fluoroscopic]] vision}}
+{{Family tree | | A01 |-| G01 |-| G02 |-| G03 | |A01='''Diagnosis'''|G01= '''1955'''|G02= ''''' Marcelo Royer'''''<br>An Argentinian [[gastroenterologist]] from Buenos Aires|G03= Developed a technique for [[duodenal]] [[biopsy]] under [[fluoroscopic]] vision}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01='''1956'''|G02= ''''' Margot Shiner, a German-British [[gastroenterologist]]'''''|G03= Developed a reliable technique for [[duodenal]] [[biopsy]] under [[fluoroscopic]] vision}}
+{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01='''1956'''|G02= ''''' Margot Shiner'''''<br>A German-British [[gastroenterologist]]|G03= Developed another technique for [[duodenal]] [[biopsy]] under [[fluoroscopic]] vision}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01='''1964'''|G02= ''''' Berger, a Switzerland [[immunologist]]'''''|G03= Detected and reported anti [[gliadin]] [[antibodies]] in Celiac children}}
+{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01='''1964'''|G02= ''''' Berger'''''<br>A Switzerland [[immunologist]]|G03= Detected and reported anti [[gliadin]] [[antibodies]] in children with celiac disease}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01='''1969'''|G02= ''''' European Society of Pediatric Gastroenterology (today ESPGHAN)'''''|G03= Present the diagnostic tool of “'''''Interlaken criteria'''''”, which was used for about 20 years}}
+{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01='''1969'''|G02= ''''' European Society of Pediatric Gastroenterology<br> (now ESPGHAN)'''''|G03= Gave the diagnostic tool of “'''''Interlaken criteria'''''”, which was used for about 20 years}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01='''1971'''|G02= ''''' Seah, a British doctor'''''|C03= Found [[Autoantibody|auto-antibody]], the anti-reticulin; showed that [[antibody]] is not necessarily an anti-food [[protein]]}}
+{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01='''1971'''|G02= ''''' Seah'''''<br>A British physician|G03= Discovered an [[Autoantibody|auto-antibody]], the anti-reticulin; showing that [[antibody]] is not necessarily an anti-food [[protein]]}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01='''1983'''|G02= ''''' Chorzelski, a [[dermatologist]] from Warsaw'''''|G03= Discovered anti-[[endomysium]] [[antibodies]] in Celiac disease and [[dermatitis herpetiformis]]}}
+{{Family tree | | | | | | G01 |-| G02 |-| G03 | |G01='''1983'''|G02= ''''' Chorzelski'''''<br>A Polish [[dermatologist]] from Warsaw|G03= Discovered anti-[[endomysium]] [[antibodies]] and [[dermatitis herpetiformis]] in celiac disease patients}}
 {{Family tree | | | | | | |!| | | | | | | | | | | }}
-{{Family tree | | A01 |-| G01 |-| G02 |-| G03 | |A01='''Treatment'''|G01= '''Recently'''|G02= ''''' Main guidelines'''''|G03= [[Agency for Healthcare Research and Quality]] (AHRQ, 2004)<ref name="urlCeliac Disease: Summary - AHRQ Evidence Report Summaries - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK11885/ |title=Celiac Disease: Summary - AHRQ Evidence Report Summaries - NCBI Bookshelf |format= |work= |accessdate=}}</ref><br> [[American Gastroenterological Association]] (AGA, 2006)<ref name="pmid17087937">{{cite journal |vauthors=Rostom A, Murray JA, Kagnoff MF |title=American Gastroenterological Association (AGA) Institute technical review on the diagnosis and management of celiac disease |journal=Gastroenterology |volume=131 |issue=6 |pages=1981–2002 |year=2006 |pmid=17087937 |doi=10.1053/j.gastro.2006.10.004 |url=}}</ref><br>North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NSPGHAN, 2005)<ref name="pmid15625418">{{cite journal |vauthors=Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, Hoffenberg EJ, Horvath K, Murray JA, Pivor M, Seidman EG |title=Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition |journal=J. Pediatr. Gastroenterol. Nutr. |volume=40 |issue=1 |pages=1–19 |year=2005 |pmid=15625418 |doi= |url=}}</ref><br>European Society of Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN, 2012)<ref name="pmid22197856">{{cite journal |vauthors=Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, Troncone R, Giersiepen K, Branski D, Catassi C, Lelgeman M, Mäki M, Ribes-Koninckx C, Ventura A, Zimmer KP |title=European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease |journal=J. Pediatr. Gastroenterol. Nutr. |volume=54 |issue=1 |pages=136–60 |year=2012 |pmid=22197856 |doi=10.1097/MPG.0b013e31821a23d0 |url=}}</ref>, and the [[National Institute for Health and Clinical Excellence]] (NICE, 2015)<ref name="urlCoeliac disease: recognition, assessment and management | Guidance and guidelines | NICE">{{cite web |url=https://www.nice.org.uk/guidance/ng20 |title=Coeliac disease: recognition, assessment and management &#124; Guidance and guidelines &#124; NICE |format= |work= |accessdate=}}</ref>}}
+{{Family tree |boxstyle=text-align: center; | | S01 |-| S02 |-| S03 |-| S04 | |S01='''Treatment'''|S02= '''Recently'''|S03= ''''' Main guidelines'''''|S04= • [[Agency for Healthcare Research and Quality]] (AHRQ, 2004)<ref name="urlCeliac Disease: Summary - AHRQ Evidence Report Summaries - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK11885/ |title=Celiac Disease: Summary - AHRQ Evidence Report Summaries - NCBI Bookshelf |format= |work= |accessdate=}}</ref><br>• [[American Gastroenterological Association]] (AGA, 2006)<ref name="pmid17087937">{{cite journal |vauthors=Rostom A, Murray JA, Kagnoff MF |title=American Gastroenterological Association (AGA) Institute technical review on the diagnosis and management of celiac disease |journal=Gastroenterology |volume=131 |issue=6 |pages=1981–2002 |year=2006 |pmid=17087937 |doi=10.1053/j.gastro.2006.10.004 |url=}}</ref><br>• North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NSPGHAN, 2005)<ref name="pmid15625418">{{cite journal |vauthors=Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, Hoffenberg EJ, Horvath K, Murray JA, Pivor M, Seidman EG |title=Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition |journal=J. Pediatr. Gastroenterol. Nutr. |volume=40 |issue=1 |pages=1–19 |year=2005 |pmid=15625418 |doi= |url=}}</ref><br>• European Society of Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN, 2012)<ref name="pmid22197856">{{cite journal |vauthors=Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, Troncone R, Giersiepen K, Branski D, Catassi C, Lelgeman M, Mäki M, Ribes-Koninckx C, Ventura A, Zimmer KP |title=European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease |journal=J. Pediatr. Gastroenterol. Nutr. |volume=54 |issue=1 |pages=136–60 |year=2012 |pmid=22197856 |doi=10.1097/MPG.0b013e31821a23d0 |url=}}</ref><br> •  [[National Institute for Health and Clinical Excellence]] (NICE, 2015)<ref name="urlCoeliac disease: recognition, assessment and management | Guidance and guidelines | NICE">{{cite web |url=https://www.nice.org.uk/guidance/ng20 |title=Coeliac disease: recognition, assessment and management &#124; Guidance and guidelines &#124; NICE |format= |work= |accessdate=}}</ref>}}
 {{Family tree/end}}
 === Discovery ===
-* From beginning of [[human being]] life on the earth, he met his [[nutritional]] demands through hunting. Whenever the conditions became severe and there were not any hunting for a while, inevitably, he came to fruits, seeds, and nuts.<ref name="urlwww.cureceliacdisease.org2">{{cite web |url=https://www.cureceliacdisease.org/wp-content/uploads/SU07CeliacCtr.News_.pdf |title=www.cureceliacdisease.org |format= |work= |accessdate=}}</ref>
+* At the beginning of [[human being|human]] life on the earth, [[nutritional]] demands were met through hunting. In severe circumstances, inability to hunt for a while, encouraged the utilization of fruits, seeds, and nuts.<ref name="urlwww.cureceliacdisease.org2">{{cite web |url=https://www.cureceliacdisease.org/wp-content/uploads/SU07CeliacCtr.News_.pdf |title=www.cureceliacdisease.org |format= |work= |accessdate=}}</ref>
-* From 10,000 years ago the mankind learnt to cultivate and agriculture. He has experienced sort of foods that has not experienced for 2.5 million years.<ref name="Guandalini20082">{{cite journal|last1=Guandalini|first1=Stefano |title=Historical Perspective of Celiac Disease|year=2008|pages=1–11|doi=10.1159/000128267}}</ref>
+* 10,000 years ago the mankind learnt to cultivate and grow agriculture. Humans have utilized foods that were not been known for 2.5 million years.<ref name="Guandalini20082">{{cite journal|last1=Guandalini|first1=Stefano |title=Historical Perspective of Celiac Disease|year=2008|pages=1–11|doi=10.1159/000128267}}</ref>
-* The main revolution of the agriculture and cultivation was of Neolithic period, in which some new sorts of [[antigens]] have produced to [[human beings]] daily regimen, such as cow, goat, and donkey milks' [[proteins]], along with various birds' eggs, and also different cereals.<ref name="urlwww.cureceliacdisease.org2" />
+* During Neolithic period, some new foods such as milk from cow, goat, and donkey, along with bird eggs, and various cereals were introduced for daily utilization of [[human beings]].<ref name="urlwww.cureceliacdisease.org2" />
-* Among the products of agriculture, wheat showing a good rate of multiplication and also good resistance to harvesting, became the main food source of agriculture mankind.<ref name="Guandalini20083">{{cite journal|last1=Guandalini|first1=Stefano |title=Historical Perspective of Celiac Disease|year=2008|pages=1–11|doi=10.1159/000128267}}</ref>
+* Amongst agricultural products, wheat showed a higher rate of growth and resistance to environmental changes. It became the main food source of human beings related to agriculture.<ref name="Guandalini20083">{{cite journal|last1=Guandalini|first1=Stefano |title=Historical Perspective of Celiac Disease|year=2008|pages=1–11|doi=10.1159/000128267}}</ref>
-* There were no problems with the new regimen for a long time, till some members of the tribe faced with new problems, after eating [[wheat]].
+* There were no problems until some members of the tribe suffered from abdominal discomfort, after eating [[wheat]] based products.
-* About 2,000 years ago, Aretaeus, a clever Greek physician from Cappadocia, has written total of 8 books about different topics of [[medicine]]. In one of his books, he completely described a patient with Celiac disease, called it '<nowiki/>'''''koiliakos'''''<nowiki/>'. It came from Greek word of ''''''koelia'''''<nowiki/>' ([[abdomen]]), represent as “if the [[stomach]] be irretentive of the food and if it pass through undigested and crude, and nothing ascends into the body, we call such persons coeliacs”.<ref name="urlwww.cureceliacdisease.org2" />
+* About 2,000 years ago, Aretaeus, a physician from Cappadocia, wrote a total of 8 books on [[medicine]]. In one of his books, he described a patient with celiac disease and named it '<nowiki/>'''''koiliakos'''''<nowiki/>', derived from a Greek word ''''''koelia'''''<nowiki/>' ([[abdomen]]). This was represented as “if the [[stomach]] be irretentive of the food and if it pass through undigested and crude, and nothing ascends into the body, we call such persons coeliacs”.<ref name="urlwww.cureceliacdisease.org2" />
-* 17 centuries later, in early 19th century, Mathew Baillie, an Scottish physician, probably unaware of Aretaeus, presented his point of view about some adult patients experiencing [[malnutrition]] and [[bloating]] [[abdomen]] along with [[chronic diarrhea]] due to specific regimen, “some patients have appeared to derive considerable advantage from living almost entirely upon rice". Unfortunately, his work was not considered so much.<ref name="urlwww.cureceliacdisease.org2" />
+* 17 centuries later, in 1812, Mathew Baillie, a Scottish physician, probably unaware of Aretaeus, presented his point of view about some adult patients experiencing [[malnutrition]] and [[bloating|bloated]] [[abdomen]] along with [[chronic diarrhea]] due to specific diet, “some patients have appeared to derive considerable advantage from living almost entirely upon rice." Unfortunately, his work was not considered much.<ref name="urlwww.cureceliacdisease.org2" />
-* In October 1887, Samuel Gee, an English leading authority in pediatrics, has gained the full credit of explanation of Celiac disease, presenting "Celiac affection" lecture to medical students; which is published next year. Gee mentioned that "If the patient can be cured at all, it must be by means of diet".<ref name="pmid4595183">{{cite journal| author=Dowd B, Walker-Smith J| title=Samuel Gee, Aretaeus, and the coeliac affection. | journal=Br Med J | year= 1974 | volume= 2 | issue= 5909 | pages= 45-7 | pmid=4595183 | doi= | pmc=1610148 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4595183  }}</ref> He also added that "the allowance of farinaceous food must be small".<ref name="pmid18431060">{{cite journal |vauthors=Losowsky MS |title=A history of coeliac disease |journal=Dig Dis |volume=26 |issue=2 |pages=112–20 |year=2008 |pmid=18431060 |doi=10.1159/000116768 |url=}}</ref> He also found the [[gluten-free diet]] as a relief, the symptoms relapse when [[gluten]] introduced again.<ref name="urlwww.cureceliacdisease.org2" />
+* In October 1887, Samuel Gee, an English leading authority in pediatrics, gained the full credit of explanation of celiac disease, presenting a lecture named "celiac affection" to medical students; which was published next year. Gee mentioned that "If the patient can be cured at all, it must be by means of diet".<ref name="pmid4595183">{{cite journal| author=Dowd B, Walker-Smith J| title=Samuel Gee, Aretaeus, and the coeliac affection. | journal=Br Med J | year= 1974 | volume= 2 | issue= 5909 | pages= 45-7 | pmid=4595183 | doi= | pmc=1610148 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4595183  }}</ref> He also added that "the allowance of farinaceous food must be small".<ref name="pmid18431060">{{cite journal |vauthors=Losowsky MS |title=A history of coeliac disease |journal=Dig Dis |volume=26 |issue=2 |pages=112–20 |year=2008 |pmid=18431060 |doi=10.1159/000116768 |url=}}</ref> He also found [[gluten-free diet]] relieved symptoms, which relapsed when [[gluten]] was introduced again.<ref name="urlwww.cureceliacdisease.org2" />
-* In 1920s, Sidney Haas, a New York city [[pediatrician]], used a new [[Dietetics|dietetic]] therapeutic option for 10 children with Celiac disease, '''''the banana diet'''; regarding his previous successful experience in treating a child with [[anorexia nervosa]] by the regimen. He presented the results as 8 of them "clinically cured" and remained 2 died.''<ref name="Haas1932">{{cite journal|last1=Haas|first1=Sidney V.|title=CELIAC DISEASE|journal=Journal of the American Medical Association|volume=99|issue=6|year=1932|pages=448|issn=0002-9955|doi=10.1001/jama.1932.02740580016004}}</ref>
+* In 1920s, Sidney Haas, a New York city [[pediatrician]], used a new [[Dietetics|dietetic]] therapeutic option for 10 children with celiac disease, '''''the banana diet'''; owing to his success in treating a child with [[anorexia nervosa]] by the diet. 8 of those children were "clinically cured" and the remaining 2 died.''<ref name="Haas1932">{{cite journal|last1=Haas|first1=Sidney V.|title=CELIAC DISEASE|journal=Journal of the American Medical Association|volume=99|issue=6|year=1932|pages=448|issn=0002-9955|doi=10.1001/jama.1932.02740580016004}}</ref>
-* In 1949, Wood, an Australian [[gastroenterologist]], invented a simple flexible biopsy tube which can be used for GI biopsies without need to [[X-ray]] or [[gastroscope]].<ref name="Wood1949">{{cite journal|last1=Wood|first1=I|title=GASTRIC BIOPSY REPORT ON FIFTY-FIVE BIOPSIES USING A NEW FLEXIBLE GASTRIC BIOPSY TUBE|journal=The Lancet|volume=253|issue=6540|year=1949|pages=18–21|issn=01406736|doi=10.1016/S0140-6736(49)90344-X}}</ref>
+* In 1949, Wood, an Australian [[gastroenterologist]], invented a simple flexible biopsy tube which could be used for GI biopsies without requiring [[X-ray]] or [[gastroscope]].<ref name="Wood1949">{{cite journal|last1=Wood|first1=I|title=GASTRIC BIOPSY REPORT ON FIFTY-FIVE BIOPSIES USING A NEW FLEXIBLE GASTRIC BIOPSY TUBE|journal=The Lancet|volume=253|issue=6540|year=1949|pages=18–21|issn=01406736|doi=10.1016/S0140-6736(49)90344-X}}</ref>
-* In 1950, Wim Dicke, a Dutch [[pediatrician]], suggested in his doctoral thesis that elimination of [[wheat]], rye, and [[Oat|oats]] from diet would be result in reasonable cure. He found that the pathological factor is [[gluten]], indeed.<ref name="DickeWeijers1953">{{cite journal|last1=Dicke|first1=W. K.|last2=Weijers|first2=H. A.|last3=KAMER|first3=J. H. v. D.|title=Coeliac Disease The Presence in Wheat of a Factor Having a Deleterious Effect in Cases of Coeliac Disease|journal=Acta Paediatrica|volume=42|issue=1|year=1953|pages=34–42|issn=0803-5253|doi=10.1111/j.1651-2227.1953.tb05563.x}}</ref>
+* In 1950, Wim Dicke, a Dutch [[pediatrician]], suggested in his doctoral thesis that elimination of [[wheat]], rye, and [[Oat|oats]] from diet would result in reasonable cure of celiac disease. He found the pathological factor to be [[gluten]].<ref name="DickeWeijers1953">{{cite journal|last1=Dicke|first1=W. K.|last2=Weijers|first2=H. A.|last3=KAMER|first3=J. H. v. D.|title=Coeliac Disease The Presence in Wheat of a Factor Having a Deleterious Effect in Cases of Coeliac Disease|journal=Acta Paediatrica|volume=42|issue=1|year=1953|pages=34–42|issn=0803-5253|doi=10.1111/j.1651-2227.1953.tb05563.x}}</ref>
-* At the same time, Wim Dicke's colleagues, Weijers and Van de Kamer, presented a way to diagnosis of the Celiac disease, [[stool]] [[fat]] measurement.<ref name="KamerWeijers1953">{{cite journal|last1=Kamer|first1=J. H. Van De|last2=Weijers|first2=H. A.|last3=Dicke|first3=W. K.|title=Coeliac Disease: An Investigation into the Injurious Constituents of Wheat in Connection with their Action on Patients with Coeliac Disease|journal=Acta Paediatrica|volume=42|issue=3|year=1953|pages=223–231|issn=0803-5253|doi=10.1111/j.1651-2227.1953.tb05586.x}}</ref>
+* At the same time, Wim Dicke's colleagues, Weijers and Van de Kamer, presented a way to diagnose celiac disease by using [[stool]] [[fat]] measurement.<ref name="KamerWeijers1953">{{cite journal|last1=Kamer|first1=J. H. Van De|last2=Weijers|first2=H. A.|last3=Dicke|first3=W. K.|title=Coeliac Disease: An Investigation into the Injurious Constituents of Wheat in Connection with their Action on Patients with Coeliac Disease|journal=Acta Paediatrica|volume=42|issue=3|year=1953|pages=223–231|issn=0803-5253|doi=10.1111/j.1651-2227.1953.tb05586.x}}</ref>
-* In 1954, John Paulley, a [[pathologist]] from Ipswich in England, discovered the [[histological]] abnormalities in [[small intestine]] lining as the main [[pathophysiology]] of Celiac disease.<ref name="Paulley1954">{{cite journal|last1=Paulley|first1=J. W.|title=Observations on the Aetiology of Idiopathic Steatorrhoea|journal=BMJ|volume=2|issue=4900|year=1954|pages=1318–1321|issn=0959-8138|doi=10.1136/bmj.2.4900.1318}}</ref>
+* In 1954, John Paulley, a [[pathologist]] from Ipswich in England, discovered the [[histological]] abnormalities in [[small intestine|small intestinal]] lining as the main [[pathophysiology]] of celiac disease.<ref name="Paulley1954">{{cite journal|last1=Paulley|first1=J. W.|title=Observations on the Aetiology of Idiopathic Steatorrhoea|journal=BMJ|volume=2|issue=4900|year=1954|pages=1318–1321|issn=0959-8138|doi=10.1136/bmj.2.4900.1318}}</ref>
 === Diagnosis ===
-* In 1955, Marcelo Royer, a [[gastroenterologist]] from Buenos Aires, developed a reliable technique for [[duodenal]] [[biopsy]] under [[fluoroscopic]] vision. He was inspired by Wood's instrument in this way.<ref name="pmid13289533">{{cite journal |vauthors=ROYER M, CROXATTO O, BIEMPICA L, BALCAZAR MORRISON AJ |title=[Duodenal biopsy by aspiration under radioscopic control] |language=Spanish; Castilian |journal=Prensa Med Argent |volume=42 |issue=33 |pages=2515–9 |year=1955 |pmid=13289533 |doi= |url=}}</ref>
+* In 1955, Marcelo Royer, a [[gastroenterologist]] from Buenos Aires, developed a technique for [[duodenal]] [[biopsy]] under [[fluoroscopic]] vision. He was inspired by Wood's instrument.<ref name="pmid13289533">{{cite journal |vauthors=ROYER M, CROXATTO O, BIEMPICA L, BALCAZAR MORRISON AJ |title=[Duodenal biopsy by aspiration under radioscopic control] |language=Spanish; Castilian |journal=Prensa Med Argent |volume=42 |issue=33 |pages=2515–9 |year=1955 |pmid=13289533 |doi= |url=}}</ref>
-* In 1956, Margot Shiner, a German-British [[gastroenterologist]], also developed a reliable technique for [[duodenal]] [[biopsy]] under [[fluoroscopic]] vision. He was inspired by Wood's instrument in this way.<ref name="Shiner1956">{{cite journal|last1=Shiner|first1=Margot|title=DUODENAL BIOPSY|journal=The Lancet|volume=267|issue=6906|year=1956|pages=17–19|issn=01406736|doi=10.1016/S0140-6736(56)91854-2}}</ref>
+* In 1956, Margot Shiner, a German-British [[gastroenterologist]], also developed a technique for [[duodenal]] [[biopsy]] under [[fluoroscopic]] vision. He was also inspired by Wood's instrument.<ref name="Shiner1956">{{cite journal|last1=Shiner|first1=Margot|title=DUODENAL BIOPSY|journal=The Lancet|volume=267|issue=6906|year=1956|pages=17–19|issn=01406736|doi=10.1016/S0140-6736(56)91854-2}}</ref>
-* In 1986, the Coeliac society on United Kingdom was founded. Similar societies also became founded around the world.
+* In the mid to late 60’s, it was understood that a [[Jejunum|jejunal]] [[biopsy]], showing [[villus]] [[atrophy]] was the best way to diagnose celiac disease. Since [[atrophy]] of [[villi]] may also have some other causes, the diagnosis could not be approved until [[gluten]] was proven to be the cause of [[atrophy]].
-* In the mid to late 60’s, the main route of diagnosing the Celiac disease was assumed as [[Jejunum|jejunal]] [[biopsy]], showing [[villus]] [[atrophy]]. But regarding that the [[atrophy]] of [[villi]] may have some other causes, the diagnosis could not be approved until it is found that the cause of [[atrophy]] is [[gluten]].
+* In 1964, Berger, a Switzerland [[immunologist]], detected and reported anti-[[gliadin]] [[antibodies]] in children with celiac disease.<ref name="urlDiagnostische Bewertung des Nachweises von Gliadin-Antikörpern bei Cöliakie | SpringerLink">{{cite web |url=https://link.springer.com/article/10.1007/BF01479129 |title=Diagnostische Bewertung des Nachweises von Gliadin-Antikörpern bei Cöliakie &#124; SpringerLink |format= |work= |accessdate=}}</ref>
-* In 1964, Berger, a Switzerland [[immunologist]], detected and reported anti [[gliadin]] [[antibodies]] in Celiac children.<ref name="urlDiagnostische Bewertung des Nachweises von Gliadin-Antikörpern bei Cöliakie | SpringerLink">{{cite web |url=https://link.springer.com/article/10.1007/BF01479129 |title=Diagnostische Bewertung des Nachweises von Gliadin-Antikörpern bei Cöliakie &#124; SpringerLink |format= |work= |accessdate=}}</ref>
+* In 1969, European Society of Pediatric Gastroenterology (now ESPGHAN), presented “'''''Interlaken criteria'''''” as a diagnostic tool, which was used for about 20 years. The criteria consisted of full remission of the symptoms on using [[gluten-free diet]], along with curing the [[atrophic]] lesions in [[GI]] lumen, and finally recurrence of the disease, once [[gluten]] was reintroduced in diet.<ref name="urlwww.cureceliacdisease.org2" />
-* In 1969, European Society of Pediatric Gastroenterology (today ESPGHAN), present the diagnostic tool of “'''''Interlaken criteria'''''”, which was used for about 20 years. The criteria composed of full remission of the symptoms upon being on [[gluten-free diet]], along with curing the [[atrophic]] lesions in [[GI]] lumen, and finally recurrence of the disease once the [[gluten]] start again.<ref name="urlwww.cureceliacdisease.org2" />
 * In 1971, Seah, a British doctor, found that the [[antibody]] is not necessarily an anti-food [[protein]], but it is actually an [[Autoantibody|auto-antibody]], the anti-reticulin.<ref name="pmid4102529">{{cite journal |vauthors=Seah PP, Fry L, Hoffbrand AV, Holborow EJ |title=Tissue antibodies in dermatitis herpetiformis and adult coeliac disease |journal=Lancet |volume=1 |issue=7704 |pages=834–6 |year=1971 |pmid=4102529 |doi= |url=}}</ref>
-* In 1983, Chorzelski, a [[dermatologist]] from Warsaw, discovered anti-[[endomysium]] [[antibodies]] in Celiac disease and [[dermatitis herpetiformis]].<ref name="ChorzelskiBeutner1984">{{cite journal|last1=Chorzelski|first1=T.P.|last2=Beutner|first2=E.H.|last3=Sulej|first3=J.|last4=Tchorzewska|first4=H.|last5=Jablonska|first5=S.|last6=Kumar|first6=V.|last7=Kapuscinska|first7=A.|title=IgA anti-endomysium antibody. A new immunological marker of dermatitis herpetiformis and coeliac disease|journal=British Journal of Dermatology|volume=111|issue=4|year=1984|pages=395–402|issn=0007-0963|doi=10.1111/j.1365-2133.1984.tb06601.x}}</ref>
+* In 1983, Chorzelski, a [[dermatologist]] from Warsaw, discovered anti-[[endomysium]] [[antibodies]] and [[dermatitis herpetiformis]] in celiac disease.<ref name="ChorzelskiBeutner1984">{{cite journal|last1=Chorzelski|first1=T.P.|last2=Beutner|first2=E.H.|last3=Sulej|first3=J.|last4=Tchorzewska|first4=H.|last5=Jablonska|first5=S.|last6=Kumar|first6=V.|last7=Kapuscinska|first7=A.|title=IgA anti-endomysium antibody. A new immunological marker of dermatitis herpetiformis and coeliac disease|journal=British Journal of Dermatology|volume=111|issue=4|year=1984|pages=395–402|issn=0007-0963|doi=10.1111/j.1365-2133.1984.tb06601.x}}</ref>
+* In 1986, the Coeliac society on United Kingdom was founded. Similar societies were also founded around the world.
 === Treatment ===
-* The main management guidelines are issued by [[Agency for Healthcare Research and Quality]] (AHRQ, 2004)<ref name="urlCeliac Disease: Summary - AHRQ Evidence Report Summaries - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK11885/ |title=Celiac Disease: Summary - AHRQ Evidence Report Summaries - NCBI Bookshelf |format= |work= |accessdate=}}</ref>, the [[American Gastroenterological Association]] (AGA, 2006)<ref name="pmid17087937">{{cite journal |vauthors=Rostom A, Murray JA, Kagnoff MF |title=American Gastroenterological Association (AGA) Institute technical review on the diagnosis and management of celiac disease |journal=Gastroenterology |volume=131 |issue=6 |pages=1981–2002 |year=2006 |pmid=17087937 |doi=10.1053/j.gastro.2006.10.004 |url=}}</ref>, the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NSPGHAN, 2005)<ref name="pmid15625418">{{cite journal |vauthors=Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, Hoffenberg EJ, Horvath K, Murray JA, Pivor M, Seidman EG |title=Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition |journal=J. Pediatr. Gastroenterol. Nutr. |volume=40 |issue=1 |pages=1–19 |year=2005 |pmid=15625418 |doi= |url=}}</ref>, the European Society of Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN, 2012)<ref name="pmid22197856">{{cite journal |vauthors=Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, Troncone R, Giersiepen K, Branski D, Catassi C, Lelgeman M, Mäki M, Ribes-Koninckx C, Ventura A, Zimmer KP |title=European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease |journal=J. Pediatr. Gastroenterol. Nutr. |volume=54 |issue=1 |pages=136–60 |year=2012 |pmid=22197856 |doi=10.1097/MPG.0b013e31821a23d0 |url=}}</ref> <br>[[National Institute for Health and Clinical Excellence]] (NICE, 2015)<ref name="urlCoeliac disease: recognition, assessment and management | Guidance and guidelines | NICE">{{cite web |url=https://www.nice.org.uk/guidance/ng20 |title=Coeliac disease: recognition, assessment and management &#124; Guidance and guidelines &#124; NICE |format= |work= |accessdate=}}</ref>.
+* The main management guidelines are issued by [[Agency for Healthcare Research and Quality]] (AHRQ, 2004)<ref name="urlCeliac Disease: Summary - AHRQ Evidence Report Summaries - NCBI Bookshelf">{{cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK11885/ |title=Celiac Disease: Summary - AHRQ Evidence Report Summaries - NCBI Bookshelf |format= |work= |accessdate=}}</ref>, the [[American Gastroenterological Association]] (AGA, 2006)<ref name="pmid17087937">{{cite journal |vauthors=Rostom A, Murray JA, Kagnoff MF |title=American Gastroenterological Association (AGA) Institute technical review on the diagnosis and management of celiac disease |journal=Gastroenterology |volume=131 |issue=6 |pages=1981–2002 |year=2006 |pmid=17087937 |doi=10.1053/j.gastro.2006.10.004 |url=}}</ref>, the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NSPGHAN, 2005)<ref name="pmid15625418">{{cite journal |vauthors=Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, Hoffenberg EJ, Horvath K, Murray JA, Pivor M, Seidman EG |title=Guideline for the diagnosis and treatment of celiac disease in children: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition |journal=J. Pediatr. Gastroenterol. Nutr. |volume=40 |issue=1 |pages=1–19 |year=2005 |pmid=15625418 |doi= |url=}}</ref>, the European Society of Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN, 2012)<ref name="pmid22197856">{{cite journal |vauthors=Husby S, Koletzko S, Korponay-Szabó IR, Mearin ML, Phillips A, Shamir R, Troncone R, Giersiepen K, Branski D, Catassi C, Lelgeman M, Mäki M, Ribes-Koninckx C, Ventura A, Zimmer KP |title=European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease |journal=J. Pediatr. Gastroenterol. Nutr. |volume=54 |issue=1 |pages=136–60 |year=2012 |pmid=22197856 |doi=10.1097/MPG.0b013e31821a23d0 |url=}}</ref>, and [[National Institute for Health and Clinical Excellence]] (NICE, 2015)<ref name="urlCoeliac disease: recognition, assessment and management | Guidance and guidelines | NICE">{{cite web |url=https://www.nice.org.uk/guidance/ng20 |title=Coeliac disease: recognition, assessment and management &#124; Guidance and guidelines &#124; NICE |format= |work= |accessdate=}}</ref>.
 ==Outbreaks==
-*There have been just one [[outbreak]] of Celiac disease in Sweden, which is summarized below:<ref name="pmid15925847">{{cite journal |vauthors=Ivarsson A |title=The Swedish epidemic of coeliac disease explored using an epidemiological approach--some lessons to be learnt |journal=Best Pract Res Clin Gastroenterol |volume=19 |issue=3 |pages=425–40 |year=2005 |pmid=15925847 |doi=10.1016/j.bpg.2005.02.005 |url=}}</ref>
+*There has just been one [[outbreak]] of celiac disease in Sweden. The details of this outbreak are summarized below:<ref name="pmid15925847">{{cite journal |vauthors=Ivarsson A |title=The Swedish epidemic of coeliac disease explored using an epidemiological approach--some lessons to be learnt |journal=Best Pract Res Clin Gastroenterol |volume=19 |issue=3 |pages=425–40 |year=2005 |pmid=15925847 |doi=10.1016/j.bpg.2005.02.005 |url=}}</ref>
-**Regarding that the Celiac disease has some [[genetic]], [[immune]] mediated and [[chronic]] features, rarely can contributed to an [[outbreak]].
+**It was established that since celiac disease has [[genetic]], [[immune]]-mediated, and [[chronic]] features, it rarely contributes to an [[outbreak]].
-**This is quite unique for Celiac disease, suggests some evolution in causal factors or environment in Swedish children population.
+**This outbreak was quite unique for celiac disease, suggesting evolution of causal factors or environmental influences on Swedish children.
-**It is assumed that every [[outbreaks]] can be caused by introducing large amounts of [[gluten]] contained foods to children, right after [[breast milk]].
+**It is assumed that an [[outbreaks|outbreak]] can be caused by introducing large amounts of [[gluten]] containing foods to the diet of children, immediately after withholding [[breast milk]].
-**By the beginning of [[outbreak]] the rise in girls was more than boys.
+**At the beginning of [[outbreak]] more girls were affected with celiac disease than boys.
-**Children that were born in summer have higher rate of Celiac disease, probably due to high [[gluten]] foods during the winter, when the [[infections]] are more common.
+**Children that were born in summer had higher rate of celiac disease, due to high [[gluten]] containing foods during winter, when the [[infections]] are more common.
 ==Landmark Events in the Development of Treatment Strategies==
-*In October 1887, Samuel Gee, an English leading authority in [[pediatrics]], has gain the full credit of explanation of Celiac disease, presenting "Celiac affection" lecture to medical students; which is published next year. Gee mentioned that "If the patient can be cured at all, it must be by means of [[diet]]".<ref name="pmid4595183" /> He also added that "the allowance of farinaceous food must be small".<ref name="pmid18431060" /> He also found the [[gluten-free diet]] as a relief, the symptoms relapse when [[gluten]] introduced again.<ref name="urlwww.cureceliacdisease.org2" />
+*In October 1887, Samuel Gee, an English leading authority in [[pediatrics]], completely explained celiac disease, presenting a lecture named "celiac affection" to medical students; which was published the year later. Gee mentioned that "If the patient can be cured at all, it must be by means of [[diet]]".<ref name="pmid4595183" /> He also added that "the allowance of farinaceous food must be small".<ref name="pmid18431060" /> He also found that the [[gluten-free diet]] relieved symptoms, which relapsed when [[gluten]] was reintroduced.<ref name="urlwww.cureceliacdisease.org2" />
 ==Famous Cases==
-*The following are a few famous cases of Celiac disease:
+*The following are a few famous cases of celiac disease:
 ** '''''Drew Brees:'''''  Star quarterback for the Saints
 ** '''''Justin Morneau:''''' Twins first baseman Justin Morneau
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 [[Category:Disease]]
 [[Category:Gastroenterology]]
-[[Category:Primary care]]
 [[Category:Rheumatology]]
 [[Category:Autoimmune diseases]]
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 [[Category:Genetic disorders]]
 [[Category:Malnutrition]]
 [[Category:Pediatrics]]
 [[Category:Dermatology]]
-[[Category:Primary care]]
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