Coeliac disease, Diverticular disease and diverticulitis

Question 1

what is coeliac disease?

Answer 1

Coeliac disease is a lifelong autoimmune disease caused by a reaction to gluten

Question 2

what are the aims of treatment in coeliac disease?

Answer 2

1) Eliminating symptoms such as: diarrhoea, bloating and abdominal pain
2) Reducing the risk of complications, including those resulting from malabsorption.

Question 3

What is the only effective treatment for coeliac disease?

Answer 3

strict, life-long, gluten-free diet

Question 4

1) Patients who have coeliac disease are at an increased risk of malabsorption of key nutrients. Which two nutrients are they normally deficient in?
2) what condition can this deficiency lead to?

Answer 4

1) Calcium and Vitamin D

2) Puts these patents at risk of osteoporosis

Question 5

Supplementation of key nutrients may be required if dietary intake is insufficient in those with coeliac disease. How should this be initiated and what advice should be provided?

Answer 5

1) initiated by trained HCP to identify the individual needs and for appropriate ongoing monitoring.
2) should be advised NOT to self-medicate with OTC vitamins or mineral supplements.

Question 6

which drug might be considered for the initial management of coeliac’s disease while awaiting for specialist advice?

Answer 6

Prednisolone

Question 7

what is diverticular disease?

Answer 7

Where diverticula (sac-like protrusions of mucosa through the muscular colonic wall) cause intermittent lower abdominal pain in the absence of inflammation or infection. (prevelance increases with age >50 )

Question 8

what is Diverticulitis?

Answer 8

When the diverticula become inflamed and infected, causing marked lower abdominal pain usually accompanied by fever, malaise, and occasionally, large rectal bleeds

Question 9

what is recommended for the treatment of symptomatic diverticular disease?

Answer 9

High-fibre diet + Bulk-forming drugs for the treatment of symptomatic diverticular disease - but lack of evidence
↳ ( also lack of evidence with rifaximin, antispasmodics, mesalazine, and probiotics in the prevention or treatment of diverticulitis)

Question 10

outline the treatment of complicated and uncomplicated diverticulitis

Answer 10

1) Complicated: require hospitalisation- treatment with IV antibacterials (covering Gram-negative organisms and anaerobes), and bowel rest.
2) Uncomplicated: low residue diet and bowel rest. Antibacterials only when the patient presents with signs of infection or is immunocompromised