Coeliac Disease Chronc Diarhoea

Question 1

What is celiac disease / celiac sprue or non-tropical sprue

Answer 1

a maladaptive autoimmune response to gluten, a protein found in many grains (e.g., wheat).

often occurs in patients with other autoimmune illnesses, as both are associated with HLA variants causing pathological immune responses

Question 2

Cause they d coeliac disease

Answer 2

Genetic predisposition with association to HLA antigens Common: HLA-DQ2 (90–95%)

Eating gliadin from grains like wheat, rye, and barley leads to an autoimmune reaction within the small intestinal wall.

Chromosomal disorders
Turner syndrome, Down syndrome

associated with autoimmune conditions: autoimmune hepatitis,
inflammatory bowel disease,
rheumatoid arthritis, sarcoidosis,
selective IgA deficiency

Question 3

PP of coeliac disease

Answer 3

individual who is genetically predisposed develops an immunological response to gliadin, an alcohol-soluble fraction of gluten.

Consumption of food containing gluten →
tissue transglutaminase is released →
modifies gliadin from gluten proteins →
pathogenic T cells react to and are activated by modified gliadin →
mediate chronic intestinal inflammation →
epithelial damage resulting in villous atrophy, crypt hyperplasia, and loss of brush border →
impaired resorption of nutrients in the SMALL Intestine→ malabsorption symptoms

Question 4

Sx of coeliac disease

Answer 4

mild or asymptomatic cases are more common than the classic presentation of the disease.

Gastrointestinal symptoms

Chronic or recurring diarrhea: steatorrhea
Flatulence, abdominal bloating, and pain
Nausea/vomiting
Lack of appetite

Extraintestinal symptoms and associations
Malabsorption symptoms: fatigue, weight loss, vitamin deficiency, iron deficiency anemia, osteoporosis, hypocalcemia

In children: failure to thrive, growth failure, delayed puberty

Dermatological associations: !!!!dermatitis herpetiformis!!!!

Neuropsychiatric symptoms: peripheral neuropathies (numbness, burning and tingling of the hands and feet) , headache, ataxia, depression, irritability

Gynecological associations: reduced fertility or infertility

Endocrine associations:
autoimmune thyroid disease, type 1 diabetes mellitus

Associated chromosomal syndromes: Turner syndrome, Down syndrome

Other associated conditions: autoimmune hepatitis, inflammatory bowel disease, rheumatoid arthritis, sarcoidosis, selective IgA deficiency[ref][ref]

Question 5

Dg of coeliac disease

Answer 5

serum antibodies tested.
diagnosis
confirmed w/ biopsy.

1)Laboratory tests
-Gold standard: IgA (anti‑)tissue transglutaminase antibody (ab against an ez released by GI cells in inflamm)
In addition to the initial diagnosis, also useful for follow-up. ( TCG decreases over time)

-Quantitative IgA test: In the case of an IgA deficiency, patients are tested for IgG-based antibodies
-IgG deamidated gliadin peptide (DGP) indications:
IgA deficiency
children under age two

Fat malabsorption can be detected by quantitative stool fat assays or qualitatively by fat stains (e.g., Sudan III stain)

2)Endoscopy with small intestine biopsy
Confirmatory test
At least five duodenal biopsies taken and histologically examined.

Histological findings characteristic of celiac disease

1. Villous atrophy
2. Crypt hyperplasia 3.Intraepithelial lymphocytic infiltration

Question 6

rx of coeliac disease

Answer 6

Lifelong gluten-free diet!!!!
-Abstain from products containing: wheat, rye, barley, spelt

Recommended foods: rice, maize, potatoes, soy beans, millet, potentially oats
70% of cases, clinical improvement occurs within two weeks after initiating the diet.

Histological improvement occurs within months after beginning the diet.

In case of secondary lactase deficiency: avoid milk products

Iron and vitamin substitution
Supplementation of calcium and vitamin D to prevent bone loss

Question 7

complication of coeiliacc disease

Answer 7

Secondary lactase deficiency (shortage of lactase caused by a problem in your small intestine)

Adenocarcinoma of the small bowel

Question 8

is it possible to prevent

coeliac disease

Answer 8

in infantcy between 17–26 weeks of age ensure, gluten-free diet that only introduces small amounts of wheat (into the supplementary diet) infants, maintaining a gluten-free diet that only introduces small amounts of wheat (into the supplementary diet) appears to have a protective effect against developing celiac disease.