Coeliac and IBS

Question 1

what is coeliacs disease?

Answer 1

Coeliac disease is a systemic autoimmune disease triggered by dietary gluten peptides found in wheat, rye, barley, and related grains

Question 2

what histocompatibility complexes are implicated in CD?

Answer 2

HLA DQ2 in 95% and HLA DQ8 in other 5%

Question 3

What are the S&S of CD?

Answer 3

stinking stools/steatorrhoea
diarrhoea
abdominal pain
bloating
nausea + vomiting
weight loss 
fatigue 
dermatitis herpetiformis

Question 4

what the investigations for CD?

Answer 4

FBC
- microcytic anaemia

IgA tTG elevations

Endomysial antibody (EMA) elevated

Small bowel endoscopy and biopsy

• atrophy and scalloping of mucosal folds; nodularity and mosaic pattern of mucosa
• subtotal villous atrophy, ↑intra-epithelial wbcs + crypt hyperplasia

Question 5

Define IBS

Answer 5

Irritable bowel syndrome (IBS) is a chronic condition characterised by abdominal pain associated with bowel dysfunction. The pain is often relieved by defecation and is sometimes accompanied by abdominal bloating.

Question 6

When should a diagnosis of IBS be considered?

Answer 6

Only diagnose ibs if abdominal pain (or discomfort) is either relieved by defecation or associated with altered stool form or bowel frequency (constipation and diarrhoea may alternate) and there are ≥2 of:

urgency
incomplete evacuation
abdominal bloating/distension 
mucous pr
worsening of symptoms after food. 

Other symptoms: nausea, bladder symptoms, backache. Symptoms are chronic (>6 months), and exacerbated by stress, menstruation, or gastroenteritis (post-infection ibs