3 - Paeds - Gastro - Coeliac

Question 1

What happens to villi? where mostly? what influences age of presentation? how long normally after wheat intro to diet?

Answer 1

Villi > shorter > absent = flat mucosa
influenced by age of gluten intro to diet
8-24m after

Question 2

How may it present?

Answer 2

FTT, distension, buttock wasting, abnormal stools, general irritability

Question 3

Children are now more likely to present ….how? OR found how?

Answer 3

less acutely
in later childhood
-mild non-specific GI Sx
-anaemia
-FTT

or identified on screening

Question 4

How to confirm diagnosis?

Answer 4

by mucosal changes on endoscopic intestinal biopsy

Question 5

How to manage this disease

Answer 5

remove all wheat/rye/barley containing products from diet -> Sx resolve
Dietician supervision

Question 6

What if diagnosis is doubtful OR they are <2y?

what if serology goes from -ve to +ve ???

Answer 6

gluten challenge later in childhood to show continuing susceptibility

adhere to gluten free diet for life