Coeliac Disease

Question 1

What is coeliac disease?

Answer 1

Coeliac disease is an autoimmune disorder characterized by gluten sensitivity.

Question 2

What is the prevalence of coeliac disease in the UK?

Answer 2

Approximately 1% of the population is affected by coeliac disease.

Question 3

Which gender is more commonly affected by coeliac disease?

Answer 3

Women are more likely to be affected, accounting for around two-thirds of cases.

Question 4

What are common gastrointestinal symptoms of coeliac disease?

Answer 4

Diarrhoea, abdominal pain, bloating, and weight loss.

Question 5

What are some non-gastrointestinal symptoms of coeliac disease?

Answer 5

Fatigue, anaemia, osteoporosis, and dermatitis herpetiformis.

Question 6

What is the primary cause of coeliac disease?

Answer 6

An autoimmune reaction to gluten, a protein found in wheat, barley, and rye.

Question 7

What genetic factors are associated with coeliac disease?

Answer 7

Strong associations with HLA-DQ2 and HLA-DQ8 alleles.

Question 8

What is the pathophysiology of coeliac disease?

Answer 8

Ingestion of gluten leads to an immune response that damages the small intestinal mucosa, resulting in villous atrophy and malabsorption.

Question 9

What are the risk factors for developing coeliac disease?

Answer 9

Family history of coeliac disease, other autoimmune disorders, and certain genetic markers (HLA-DQ2/DQ8).

Question 10

What clinical examination findings might suggest coeliac disease?

Answer 10

Signs of malnutrition, pallor (due to anaemia), abdominal distension, and dermatitis herpetiformis.

Question 11

What initial blood tests are useful in diagnosing coeliac disease?

Answer 11

Anti-tissue transglutaminase antibodies (anti-TTG) and total IgA levels.

Question 12

What is the role of endoscopy in coeliac disease diagnosis?

Answer 12

To obtain small bowel biopsies for histological examination, confirming villous atrophy.

Question 13

What are common differential diagnoses for coeliac disease?

Answer 13

Irritable bowel syndrome, inflammatory bowel disease, lactose intolerance, and wheat allergy.

Question 14

What is the mainstay of management for coeliac disease?

Answer 14

A lifelong strict gluten-free diet.

Question 15

What complications can arise from untreated coeliac disease?

Answer 15

Hyposplenism, iron deficiency anaemia, malnutrition, osteoporosis, small bowel T-cell lymphoma, and vitamin B12 and folate deficiency.

Question 16

How does coeliac disease affect nutrient absorption?

Answer 16

Damage to the small intestinal mucosa leads to malabsorption of nutrients, including iron, calcium, vitamin D, vitamin B12, and folate.

Question 17

What is dermatitis herpetiformis?

Answer 17

A chronic, itchy, blistering skin condition associated with coeliac disease.

Question 18

Why might patients with coeliac disease develop osteoporosis?

Answer 18

Malabsorption of calcium and vitamin D can lead to decreased bone mineral density.

Question 19

What is the significance of HLA-DQ2 and HLA-DQ8 in coeliac disease?

Answer 19

These genetic markers are present in the majority of individuals with coeliac disease and are used to assess genetic susceptibility.

Question 20

Can coeliac disease present without gastrointestinal symptoms?

Answer 20

Yes, some individuals may have non-gastrointestinal symptoms or be asymptomatic.

Question 21

What is the recommended dietary advice for someone with coeliac disease?

Answer 21

Complete avoidance of gluten-containing foods, including those made with wheat, barley, and rye.

Question 22

How is adherence to a gluten-free diet monitored in coeliac disease patients?

Answer 22

Regular follow-up with healthcare providers, monitoring of symptoms, and periodic measurement of anti-TTG antibodies.

Question 23

What is the role of a dietitian in managing coeliac disease?

Answer 23

To provide education on a gluten-free diet, ensure nutritional adequacy, and offer support for dietary adherence.

Question 24

Are oats safe for individuals with coeliac disease?

Answer 24

Pure, uncontaminated oats may be safe for some individuals, but cross-contamination with gluten-containing grains is a concern; it’s best to consult with a healthcare provider.

Question 25

What is the potential impact of coeliac disease on pregnancy?

Answer 25

Untreated coeliac disease can lead to complications such as infertility, miscarriage, and low birth weight; adherence to a gluten-free diet can improve outcomes.