Coeliac disease and IBS Flashcards
What are the symptoms of Coeliac disease?
Abdominal pain, weight loss, diarrhoea, steatorrhoea, N&V
Do patients with coeliac disease present with abdominal pain?
Yes
What are the deficiency signs of Coeliac disease?
Anaemia (decrease in ferritin, B12 and folate due to villous atrophy), bleeding disorders (decreased vitamin K), neurological features such as neuropathy
What investigations would you run if you suspected Crohn’s disease?
Hb (v), RCDW (^), Haematinics (v)
Anti-transglutaminase (check IgA in addition to ensure it is a particular IgA deficiency)
If antibodies are high proceed to duodenal biopsy whilst on a gluten containing diet and crypt hyperplasia.
What HLA’s can you test for if there is any doubt of the diagnosis?
HLADQ2 and HLADQ8
What is the management of patients with Coeliac disease?
Lifelong gluten free diet
Prescribing gluten free bread, pasta, flour
What general foods are ok for Coeliac patients?
Rice, soya, potatoes, sugar are all ok.
What skin changes can sometimes be observed in patients with Coeliacs disease?
Dermatitis herpetiformis
What are the complications of Coeliacs disease
Hyposplenism
Anaemia
Dermatitis Herpetiformis
GI T cell lymphoma/malignancy
At what age is IBS most prevalent?
<40 years old
In what sex is IBS more prevalent?
Females 2: Males 1
How do you diagnose IBS?
Recurrent abdominal pain or discomfort associated with at least 2 of the following:
- Relief by defaecation
- Altered stool form
- Altered bowel frequency (may alternate from diarrhoea to constipation)
What are some of the symptoms of IBS
- Intermittent diarrhoea and constipation
- Abdominal bloating/distension
- Mucus present in the stools
- Worsening symptoms with food
- Symptoms are often chronic (occurring for longer than 6 months)
What commonly exacerbates IBS?
Menstruation, stress and gastroenteritis
What signs may you find on examination?
Examination is quite often normal
General abdominal tenderness on palpation can occur
