Gastrointestinal Health: Gluten Related Disorders Flashcards
Q: What are the most commonly recognized gluten-related disorders?
A: The most recognized gluten-related disorders are:
Coeliac disease (autoimmune).
Wheat allergy (allergic).
Non-coeliac gluten sensitivity (innate immunity).
Q: What is wheat allergy?
A: Wheat allergy is an IgE-mediated allergic response that can develop within minutes to hours of wheat exposure (digestion or inhalation), commonly affecting children but often outgrown by age 16.
Q: What are the symptoms of wheat allergy?
A: Symptoms include swelling of the mouth/throat, hives, itchy rash, nasal congestion, headache, nausea, vomiting, GORD, difficulty breathing, diarrhea, and anaphylaxis.
Q: How is wheat allergy diagnosed and managed?
A: Wheat allergy is diagnosed via a skin prick test and managed by strict avoidance of wheat. Severe cases may require carrying an adrenaline auto-injector (EpiPen) and wearing an emergency card or bracelet.
Q: What is coeliac disease (CD)?
A: Coeliac disease is an autoimmune condition where gluten triggers an immune response that attacks the mucosal lining of the small intestine, causing villous atrophy and malabsorption.
Q: What are the symptoms and complications of coeliac disease?
A: Symptoms include abdominal pain, diarrhea, steatorrhoea, fatigue, anxiety, weight loss, and anemia. Complications include malabsorption (e.g., B12, iron), osteoporosis, and anemia.
Q: What is the pathophysiology of coeliac disease?
A: Coeliac disease involves an immune response to gliadin (a gluten peptide) that damages the intestinal villi. Gliadin upregulates zonulin, increasing intestinal permeability, and triggers an immune attack via antigen-presenting cells.
Q: How is coeliac disease diagnosed?
A: Diagnosis involves blood tests for IgA anti-tTG and anti-endomysial antibodies. Genetic testing for HLA-DQ2 or HLA-DQ8 may be done. The gold standard is a duodenal biopsy to detect villous atrophy.
Q: What is the natural support approach for coeliac disease?
A: Coeliacs must follow a lifelong gluten-free diet. Avoid cross-reactive foods, support gut healing (e.g., specific carbohydrate diet), address nutritional deficiencies, and support intestinal barrier repair.
Q: What is non-coeliac gluten sensitivity (NCGS)?
A: NCGS is a condition where people experience GI and extra-intestinal symptoms after gluten ingestion without having coeliac disease or wheat allergy.
Q: What are the key symptoms of non-coeliac gluten sensitivity (NCGS)?
A: Symptoms include bloating, abdominal pain, diarrhea, nausea, GORD, tiredness, headache, brain fog, joint pain, and anxiety.
Q: How is NCGS diagnosed?
A: NCGS is diagnosed by exclusion, meaning symptoms resolve when gluten is removed from the diet and return when gluten is reintroduced.
Q: What foods should be avoided in a gluten-free diet?
A: Avoid bread, pasta, cereals, cakes, sausages, soy sauce, malt, barley, rye, and other foods containing wheat. Be cautious of cross-contamination and highly processed gluten-free foods.
