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Coeliac Disease

From Mediwikis

The gliadin portion of gluten provokes an autoimmune response in small intestine, leading to villous atrophy, flattening of the mucosa, and a reduced ability to absorb nutrients from food. There is a certain heritability to the disease, with a 1/10 chance of developing it, if a first degree relative has it.

Signs/Symptoms

Typically begin at 8–24 months when the child is weaned onto gluten-containing foods, however it is most commonly diagnosed in adults between the ages of 40 and 50. Children:

  • Weight Faltering
  • Abdominal distension
  • Mouth ulcers
  • Abnormal stools- pale, loose, steatorrhoea.

Adults:

  • Fat soluble vitamin deficiencies- A,D, E and K.
  • Anaemia
  • Intermittent abdominal pain
  • Excess flatulence
  • Weight loss

Investigations

  • IgA transgluaminase antibodies as a screen
  • Endoscopy with small intestine biopsy:
    • Villous atrophy
    • Crypt Hypertrophy

Management

The only solution is a Gluten Free diet. Failure to comply can lead to relapse of symptoms.

  • Avoid wheat, rye, barley
  • Gluten challenge later in life, to confirm diagnosis