ASGE Annual GI Advanced Practice Provider Course - Day Two (On-Demand)

20_Celiac Disease - Olmstead

Pdf Summary

Celiac disease is a common autoimmune disorder that affects the small intestine's ability to absorb nutrients in response to dietary gluten. It has an increasing incidence and typically presents between the ages of 10 and 40. The disease is associated with specific genetic markers, and there is a higher incidence among individuals of Northwestern European descent and those with first or second-degree relatives who have the disease.<br /><br />Common symptoms of celiac disease include weight loss, diarrhea, malabsorption, growth failure, dyspepsia, and bloating. There are also non-classical symptoms such as iron deficiency anemia, osteoporosis, psychiatric disorders, and headaches. Diagnosis involves testing for specific antibodies and may require an upper endoscopy with duodenal biopsy, even if serology is negative. It is important to conduct diagnostic testing while the patient is on a gluten-containing diet.<br /><br />Management of celiac disease involves lifelong adherence to a gluten-free diet, identification and treatment of nutritional deficiencies, and ongoing follow-up with a multidisciplinary team. In some cases, refractory celiac disease may occur, which requires further evaluation and potential treatment adjustments.<br /><br />It is essential to monitor for persistent or new symptoms, conduct repeat upper endoscopies with biopsies, and repeat serologies to verify normalization. Concurrent disorders, such as lactose intolerance, irritable bowel syndrome, and small bowel bacterial overgrowth, should also be recognized and managed.<br /><br />Patient education is crucial in promoting adherence to the gluten-free diet and avoiding long-term complications. Follow-up programs and routine appointments with a dietician are recommended to ensure compliance and address any ongoing concerns.<br /><br />Overall, celiac disease is a chronic condition that requires lifelong management through dietary modifications and close monitoring of symptoms and serological markers.

Keywords

Celiac disease

autoimmune disorder

small intestine

nutrient absorption

gluten

genetic markers

symptoms

diagnosis

gluten-free diet

management