ASGE Annual GI Advanced Practice Provider Course (Virtual) - Clinical Case-Based Learning (Day Two) | April 2023-Celiac Disease and Other Diseases of the Small Bowel

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This document provides information on celiac disease and other small bowel disorders. The content includes the etiology, clinical presentation, diagnosis, management, and monitoring of celiac disease and small intestinal bacterial overgrowth (SIBO).<br /><br />Celiac disease is a common autoimmune disorder that affects the small intestine in response to dietary gluten. The condition is most common in individuals of Northwestern European descent and is associated with certain genetic factors. Classic symptoms include weight loss, diarrhea, and malabsorption, but there are also nonclassical symptoms such as iron deficiency anemia and psychiatric disorders.<br /><br />The diagnosis of celiac disease involves serological testing, such as anti-tissue transglutaminase (TTG) antibodies, as well as an endoscopy with duodenal biopsy. It is important for patients to be on a gluten-full diet during diagnostic testing. Treatment for celiac disease involves lifelong adherence to a gluten-free diet and management of nutritional deficiencies.<br /><br />Non-celiac gluten sensitivity is another condition that can cause similar symptoms to celiac disease but does not involve autoimmune-mediated damage to the small intestine. Management may include a low FODMAP diet.<br /><br />SIBO is a clinical syndrome characterized by excessive bacteria in the small bowel. It can cause symptoms such as bloating, diarrhea, and abdominal pain. Diagnosis is typically done through breath tests. Treatment options for SIBO include antibiotics and dietary interventions such as a low FODMAP diet.<br /><br />It is important to monitor patients with celiac disease for persistent or new symptoms and to repeat diagnostic tests as needed to ensure adherence to a gluten-free diet. Other concurrent disorders that may cause similar symptoms should also be considered.<br /><br />Patient education and engagement are crucial in the management of these conditions. Referral to dieticians and providing resources for gluten-free diets can be helpful. Continuous follow-up and multidisciplinary care are recommended for optimal management.<br /><br />Overall, this document provides a comprehensive overview of celiac disease, non-celiac gluten sensitivity, and SIBO, including their etiology, diagnosis, management, and monitoring. It highlights the importance of early detection, proper diagnosis, and ongoing patient support in the management of these conditions.

Asset Subtitle

Jill Olmstead, DNPc, ANP-BC, CCS-P, FAANP

Keywords

celiac disease

small bowel disorders

etiology

diagnosis

management

gluten

nutritional deficiencies

non-celiac gluten sensitivity

SIBO

patient education