COELIAC DISEASE

Question 1

WHAT IS COELIAC DISEASE AND ITS CONSEQUENCES TO SMALL INTESTINES?

Answer 1

• Autoimmune disease that arises from an autoimmune response to gliadin fraction of gluten.
• This immune response leads to gastrointestinal symptoms and malabsorption

Question 2

WHAT CHANGES OCCUR IN THE SMALL INTESTINES AS A RESULT OF COELIAC DISEASE?

Answer 2

1) Villous atrophy
2) Hypertrophy of intestinal crypts
3) Mucosal damage
4) Lymphocyte infiltration of epithelium and lamina propria

Question 3

WHAT ARE THE SYMPTOMS OF COELIAC DISEASE?

Answer 3

1) Diarrhoea - possibly steatorrhea
2) Weight loss
3) Flatulence
4) Abdominal pain
5) Bloating
6) Nausea and vomiting
7) Fatigue
8) Osteoporosis

Question 4

WHAT ARE THE SIGNS OF COELIAC DISEASE?

Answer 4

1) Bloating
2) Anaemia - impaired iron absorption
3) Hypocalcaemia - osteoporosis

Question 5

WHAT ARE THE NEUROLOGICAL SYMPTOMS OF COELIAC DISEASE

Answer 5

1) gluten ataxia - damage to cerebellum, responsible for controlling walking balance, limb coordination, eye movements and speech. Leads to clumsiness, loss of balance and uncoordinated movements leading to a tendency to fall and slurred speech.
2) glute neuropathy - numbness and tingling

Question 6

WHAT INVESTIGATIONS ARE CARRIED OUT FOR COELIAC DISEASE?

Answer 6

1) FBC - anaemia
2) IgA-tTG (antibody test for tissue transglutaminase) - raised in coeliac but not diagnostic test in adult patients.
3) OGD (oesophago-gastroduodenoscopy) and duodenal biopsy - diagnostic and done when serology positive

Question 7

WHAT IS OBSERVED IN OGD AND DUODENAL BIOPSY?

Answer 7

• villous atrophy
• intra-epithelial lymphocytes
• crypt hypertrophy

Question 8

WHERE IS GLUTEN FOUND?

Answer 8

• barley
• rye
• oats
• wheat

Question 9

WHAT IS THE TREATMENT FOR COELIAC DISEASE?

Answer 9

• lifelong gluten free diet

Question 10

SHOULD PATIENTS STOP EATING THERE NORMAL DIET WHEN A CASE OF COELIC DISEASE IS SUSPECTED?

Answer 10

• no, patients should continue eating normal diet until diagnosis is made.