Coeliac Disease

Question 1

What is coeliac disease?

Answer 1

Inflammatory condition of the small intestinal mucosa induced by the ingestion of gluten

Question 2

Treatment for coeliac disease

Answer 2

Lifelong adherence to gluten free diet

Question 3

Symptoms where serological testing should be offered

Answer 3

Persistent or unexplained abdominal or gastrointestinal symptoms, Faltering growth, Prolonged fatigue, Unexpected weight loss, Severe or persistent mouth ulcers, Unexplained iron, vitamin B12 or folate deficiency, Type 1 diabetes at diagnosis, Auto-immune thyroid disease at diagnosis, IBS in adults, First degree relatives of people with coeliac disease

Question 4

Presenting conditions where serological testing should be offered

Answer 4

Metabolic bone disorder, Unexplained neurological symptoms, Unexplained sub fertility or recurrent miscarriage, Persistently raised liver enzyme with unknown cause, Dental enamel defects, Downs syndrome, Turner Syndrome

Question 5

First choice serological test for coeliac disease

Answer 5

IgA tissue transglutaminase (tTGA)

Question 6

What must patients do before serological testing?

Answer 6

Be following a gluten free diet

Question 7

Next step in diagnosis of coeliac disease after serological testing

Answer 7

Biopsy

Question 8

What is a gluten free diet?

Answer 8

Complete avoidance of all wheat, barley and rye

Question 9

Foods wehre gluten is found

Answer 9

Wheat, barley and rye and products that contain these, beer, lager, barley water, batters and thickened sauces, cakes, pastries, ice cream cones, wafers, biscuits, crackers, couscous, bulgur wheat, semolina, breads, pasta, breakfast cereals, wheat/rye flours

Question 10

What constitutes gluten free?

Answer 10

20 ppm of gluten or less

Question 11

What constitutes low gluten?

Answer 11

21-100 ppm of gluten or less

Question 12

Protein present in oats that is similar to gluten

Answer 12

Avenin

Question 13

Typical monthly prescription of a child age 7-10 with coeliac disease

Answer 13

3x loaves of white bread, 3 x packs of fibre rolls, 1 x pack of white flour mix, 1 x pack of pasta (500g), 1 x pack of breakfast cereal, 1 x pack of pizza bases

Question 14

Typical monthly prescription of a male aged 18-59 with coeliac disease

Answer 14

8 x loaves of fresh bread, 2 x packs of fibre flour mix, 1 x pack of pasta (250g), 1 x pack of pizza bases, 1 x pack of crackers, 2 x packs of breakfast cereal

Question 15

Typical monthly prescription of a female aged 19-74 with coeliac disease

Answer 15

2 x loaves of fibre bread, 2 x packs of white rolls, 1 x pack of white flour mix, 1 x pack of fibre flour mix, 1 x pack of pasta (500g), 2 x pack of pizza bases, 1 x pack of crackers, 1 x pack of breakfast cereal