Celiac disease

Question 1

Whom to consider for celiac disease?

Answer 1

diarrhea from malabsorpotion or pancreatic insufficiency w/

-chronic abdominal pain
-unexplained nutritional deficiencies (Fe and AEDK vits)
-

Question 2

complications of celiac disease

Answer 2

• osteoporosis
• decrease splenic function
• neuropathy
• infertility/recurrent miscarriage
• small bowel lymphoma (rare long term untreated)

Question 3

general principles of diagnosis

Answer 3

avoid starting gluten free diet until testing is complete

• anti TTG IgA
• total IgA (IgA deficiency pts at risk of false negative) and should have IgG based TTG

If initial testing negative but high suspicion refer for EGD

borderline results? anti endomysial antibody

Question 4

management

Answer 4

• lifelong gluten free diet (no wheat , barley, or rye)
• takes 6-24m for intestines to heal
• screen for complications Fe, folate, vit D, vit B12
• consider DXA scan