Coeliac Disease and Pernicious Anaemia Flashcards
what diseases affect the small bowel?
coeliac disease, pernicious anaemia, Crohn’s disease, infections, tumours
what is coeliac disease?
sensitivity to alpha gliaden component of gluten
what is the main cereal for coeliacs to avoid?
wheat
what are the symptoms of coeliac disease
depression/anxiety, fatigue/tiredness, bloating, lack of motivation, brain fog, headaches, difficulty losing weight, digesting issues, skin issues, irritability
what is the aetiology of coeliac disease?
genetic susceptibility, environmental trigger, consumption of gluten, T lymphocytes damage mucosal tissue, villous atrophy
why does coeliac disease occur?
due to gluten alpha gliaden component passing through the bowel which causes an immune reaction.
what happens as the projections of the villi are lost?
surface area for absorption is also lost
what are the effect of jejunal atrophy?
growth failure, oral ulceration
what are the classic symptoms of coeliac disease?
weight loss, lassitude, weakness, abdominal pain/swelling, diarrhoea, oral aphthae, tongue papillary loss, steatorrhoea, dysphagia
what are the malabsoprtion issues for coeliac disease?
iron, folate, vitamin B12, fat
what investigations are used for coeliac disease?
autoantibody test, jejunal biopsy, faecal fat, haematinics
what is the autoantibody test used for coeliac disease?
serum transglutaminase (TTG)
what happens to faecal fat with coeliac disease?
it is increased with malabsorption
if a coeliac has a gluten free diet what is the outcome?
reversal of jejunal atrophy, improved well-being, reduced risk of lymphoma
what skin disease is associated with coeliac disease?
dermatitis herpetiformis
what skin conditions are seen with coeliac disease?
oral ulceration and blisters, granular IgA deposit in skin and mucosa - itchy and blisters
what is pernicious anaemia caused by?
vitamin B12 deficiency, disease of gastric parietal cells, inflammatory bowel disease of terminal ileum, bowel cancer at ileo-coecal junction
what does vitamin B12 need to be absorbed?
intrinsic factor from gastric parietal cells, functioning of a discrete area of the terminal ileum
what is the best test for pernicious anaemia?
the antibody test
what is the patients responsibility for vitamin B12 deficiency treatment?
a diet with an adequate quantity of vitamin B12, taking vitamin B12 supplements if prescribed
what is the medical responsibility for vitamin B12 deficiency treatment?
arrange IM injections of vitamin B12 if GI absorption is not possible
