Gastrointestinal Diseases - Coeliac Disease

Question 1

Define Coeliac Disease (CD).

• Definition
• Causes
• Prevalence
• Symptoms (different presentations)

Answer 1

DEFINITION:
Coeliac disease is an inflammatory, autoimmune condition of the small intestinal mucosa that is induced by the ingestion of gluten.
Causes villous atrophy resulting in malabsorption of nutrients.

CAUSES:
- autoimmune: T1DM
- genetic: HLA-DQ gene
- environmental: infection, early intro to wheat/intro wheat without breast milk.

PREVALENCE:
- UK prevalence: 1 in 100 people
Affects people from all ethnic groups
- most common in people originating in Europe, North America and Australia.
- Rarely seen in Afro-Caribbean backgrounds

SYMPTOMS:
- Classic CD:
Malabsorption
Diarrhoea
Weight loss
- Non classical CD:
Constipation
Anaemia
Osteoporosis
Neurological disorders
Dermatitis
- Subclinical:
Nil symptoms

Question 2

What are the consequences of untreated CD?

Answer 2

• osteoporosis
• hepatitis
• IDA
• GI disturbance: vomiting, diarrhoea, malabsorption
• weight loss
• neurological disorders: anxiety, depression, seizures

Question 3

What is the treatment of CD?

Answer 3

• lifelong avoidance of gluten
• management of the consequences of CD

Question 4

What are some gluten containing foods?

Answer 4

• wheat, rye, barley, spelt
• processed foods often contain hidden gluten