coeliac + IBS Flashcards
(12 cards)
complicaations of coeliac
anaemia - iron, folate +B12
hyposplensism
osteoporosis, osteomalacia
lactose intolerance
subfertility!
enteropathy-assoc T cell lymphoma
what part of chldhood usually trggers coeliac
introduction of cereals! 3 ish
- falure to thrve
- darrhoea
- abdo distension
definitive diagnosis of coeliac
= endoscopic interstinal biopsy
duodenal/jejunal biopsy showing subtotal villous atrophy
how long must patients eat gluten before testing
at least 6 weexs
serology test for coeliac
TTG + IgA antibodies
(total IgA + IgA tTG)
endoscopic findings supportive of coeliac
villous atrophy !!
crypt hyperplasia
- increase in intraepithelial lymphocytes
- lamina propria infiltration with lymphocytes
notable gluten free foods
rice
potatoes
corn (maize)
management coeliac
gluen free
pneumococcal vaccine evry 5yrs
–> functional hyposplenism
when aa diagnosis of IBS should be considered
6 months of -
- Abdo pain +/-
- Bloating +/-
- Change in bowel habit
ABC
primary care IBS screen
FBC
ESR/CRP
coeliac disease screen (TTG)
management of IBS
based on predominant sx -
- pain, cramping, bloating = antispasmodic agent (mebeverine)
- constipation - laxative (NOT lactulose)
diarrhoea = loperamide
constipation in IBSSS thats not responded to llaxaatives
linaclotide
- if theyve had for at least 12 months
