Gastro - Coeliac disease Flashcards

1
Q

what is the pathophysiology of CD?

A

Immune-mediated, inflammatory systemic disease provoked by gliadin component of gluten in genetically susceptible people.

Immune response results in GI epithelium damage: villous atrophy, deepening of crypts and lymphocyte invasion of epithelium.

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2
Q

describe and expain the common features of CD

A
  1. diarrhoea +/- steatorrhoea: increased osmotic load from lack of carb and protein digestion
  2. weight loss and fatigue: nutrient, mineral and fat-soluble vitamin malabsorption
  3. flatulence and bloating: increased bacterial fermentation
  4. abdo pain and cramping
  5. sensory loss in hands (peripheral neuropathy), other neurological symptoms, inc. migraine: toxin malabsorption
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3
Q

which Ix should be performed in a pt with suspected CD

A
  1. Bloods
    - total IgA and IgA tTG
    - FBC: anaemia in 50%
    - vitB12, folate and ferritin: ?deficiency
    - calcium: ?deficiency
    - LFTs: may show raised transaminases which should return to normal on GFD
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4
Q

how would you manage a pt with CD

A

lifelong strict GFD

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5
Q

describe possible complications of untreated CD

A
  1. nutrient deficiencies, e.g. vitD and iron
  2. osteoporosis
  3. small bowel adenocarcinoma and lymphoma
  4. ulceratitive jejunitis and strictures (long0standing)
  5. functional hyposplenism/splenic atrophy
  6. infertility and poor foetal outcome (resolves on GFD)
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