A Simple Guide to Coeliac Disease

A Simple Guide to Coeliac Disease
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What is Coeliac Disease?
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Coeliac Disease(Gluten Enteropathy) is a chronic disease of the small intestine which affects the lining of the small intestine to develop abnormalities on contact with gluten.

The small bowel mucosa shows
1.villous atrophy
2.columnal to cuboidal changes in absorbing cells
3.infiltration of lamina propia with lymphocytes and plasma cells

Who is affected by Coeliac Disease?
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Coeliac Disease is more common in people with certain HLA antigens and blood group O.

There is a possibility of enzyme deficiency and abnormal immunological response.

Coeliac Disease can be found in all ages but are more common in the 10-30 years age group.

What is the Cause of Coeliac Disease?
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The exact cause of Coeliac Disease is not known.

It has been suggested that an autoimmune disease is the main cause of Coeliac Disease.

A protein produced by the immune system, called HLA antigen may be a possible cause of the body's reaction in the lining of the  small intestinal tract resulting in inflammation.

What are the Symptoms and signs of Coeliac Disease?
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Symptoms varies from mild to severe:

1.severe abdominal pain, bloating

2.diarrhea and steatorrhea

3.Weight loss despite good appetite and intake

4.edema

5.glossitis

6.apthous ulcers

7.finger clubbing

8.hypotension

9.Polyneuritis

10.psychiatric symptoms

In children there may be:
1.failure of weight gain
2.irritability
3.general malaise

How do you make the Diagnosis of Coeliac Disease?
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1.A history of abdominal pain , diarrhea and weight loss

2.small bowels radiology

3.D-xylose absorption study

4.fecal fat assessment

5.Jejunal biopsy 

What are the complications of Coeliac Disease?
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1.weight loss

2.Nutrition: malabsorption and vitamin deficiency

What is the treatment of Coeliac Disease?
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Treatment is :
Control of Diet
1.gluten free diet especially wheat, oats, barley, rye
use rice corn potato in place
2.avoid beer, ale, whisky, vodka which contains a lot of gluten
3.Special diet for gluten sensitive patients
4.Question diet and review diagnosis if no response

Medication

1.Antispasmotic medication for abdominal pain

2.Oral corticosteroids may help in patients not responding after 3 months of careful adherence to diet
Start with high doses at first, followed by reduction of dosage.
These are for short term use only because of the side effects.

3.Correction of anemia and nutritional deficiencies is important to enhance the immune system

What is the prognosis of Coeliac Disease?
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The prognosis depends on the conition of the disease

Improvement occurs within 1-3 days following institution of diet seen in 30% of patients.
80% will respond within a month.
the remaining 20%may take up to 2 years for symptoms control.

There may be recurrence if therapy is stopped.

What are preventive measures in Coeliac Disease?
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A nutritious diet with vitamin supplements can strengthen the body resistance against illness.
A gluten free diet will prevent recurrence