Coeliac Disease

Question 1

What is coeliac disease?

Answer 1

T-cell mediated autoimmune disease of small bowel in which there is PROLAMIN (alcohol soluble proteins in wheat, barley, rhye) intolerance. This leads to villous atrophy and malabsorption.
HLA-DQ2 association.

Question 2

How does coeliac disease present?

Answer 2

Steatorrhoea.
Abdo pain.
Bloating.
Nausea and vomiting.
Ulcers.
Angular stomatitis. 
Weight loss.
Iron deficiency anaemia.

Question 3

How do you make a diagnosis of coeliac disease?

Answer 3

Antibody serology.

Duodenal biopsy and endoscopy, showing subtotal villous atrophy and crypt hyperplasia.

Question 4

What is the treatment for coeliac disease?

Answer 4

Life-long gluten free diet.

Question 5

What are the possible complications of coeliac disease?

Answer 5

Anaemia (if presenting symptom screen for coeliac with anti-TTG).
Secondary lactose intolerance.
GI T-cell lymphoma (rare, suspect if weight loss persists).
Risk of malignancy.