Coeliac Disease

Question 1

Coeliac Disease Definition

Answer 1

Coeliac’s Disease (gluten-sensitive enteropathy) is the most common cause of small bowel malabsorption in the West.

Question 2

Coeliac Disease Pathophysiology

Answer 2

Coeliac Disease is the result of an allergic reaction to the gliaden fraction of wheat germ. This causes an increase in the intraepithelial lymphocytes in small intestinal villi. This progresses to flattening of the intestinal villi (villous atrophy).

Question 3

Coeliac Disease Presentation

Answer 3

1/3 are asymptomatic

GI upset

• Steatorrhea & diarrhoea
• Abdominal pain
• N&V
• Bloating

Failure to thrive
Fe deficiency anaemia
Fatigue
Weight loss
Osteomalacia
Dermatitis herpetiformis
- chronic blistering skin condition characterised by blisters filled with a watery fluid

Question 4

Coeliac Disease Investigations

Answer 4

• Antibodies
• • Anti-endomysial
• • Transglutaminase (TTG)
• • alpha-gliadin
• Endoscopy and distal duodenal biopsy - seeking flat mucosa

Question 5

Coeliac Disease Management

Answer 5

Gluten-Free Diet

Vitamin and Fe replacement