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COELIAC DISEASE

COELIAC DISEASE. Noreen Mahmood. What is Coeliac disease?. Gluten sensitive enteropathy” or “Coeliac sprue” Condition in which gluten causes damage to the small intestine & interferes with absorption of nutrients. Gluten is a protein found in many different things. Risk Factors.

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COELIAC DISEASE

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  1. COELIAC DISEASE Noreen Mahmood

  2. What is Coeliac disease? • Gluten sensitive enteropathy” or “Coeliac sprue” • Condition in which gluten causes damage to the small intestine & interferes with absorption of nutrients. • Gluten is a protein found in many different things

  3. Risk Factors • Genetic disease (10% chance if 1st degree relative) • AGE: can be any age even >60yrs • SEX: equal • Other Autoimmune diseases • May be triggered after surgery, pregnancy, child birth, viral infection or severe emotional stress.

  4. Prevalence-High! • Coeliac society: 1:100 (true prevalence) • Recent research:1:300 (diagnosed) • More common in some areas as Italy, west coast of Ireland.

  5. Adults: bowel symptoms. varied symptoms as Tiredness Unexplained anemia Bone or joint pain Depression Infertilty Dermatitis Herpetiformis Children: irritability, poor appetite, stools pale & bulky, D&V, Delayed growth. BMJ2006 -Consider (&if necessary discount) CD before diagnosis of IBS if Sx suggest/FHx/Dm/Thyroid disease Presentation

  6. How to diagnose? • Blood tests: Anaemia-FBC, B12, folate, ferritin • Calcium level • Antibody test: Anti-endomysial, IgA, TTG(tissue transglutaminase). NB test when on normal diet. • Endoscopy with Biopsy –for definite diagnosis.

  7. Treatment • Information: www.coeliac.org.uk & dietician • Gluten-free diet (adherence with f/u & scrips) • Vitamins and minerals (?esp pregnancy) • Treat constipation-Rice bran or fybogel. • Dapsone – DH • Refer Unresponsive coeliac disease (may require steroids) & any pr bleeding • ACHIEVE: complete healing of small intestine in 3-6m in kids & young adults

  8. Longer term management • Annual Review for • BMI • Symptoms • Bloods (incl EMA to track adherence) • DEXA (postmenopausal ,>55yr and fragility ) • Calcium & Vit D in elderly & housebound • Immunisations

  9. Key Points • Consider Coeliac Disease in IBS/TATT patients • Ensure patients are fully diagnosed • Ensure prescriptions given for minimum monthly amount • Review annually (though not a QOF point!) THANK YOU - ANY QUESTIONS?

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