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Celiac Disease

Michelle E Duffelmeyer, MD and Chelsea E Robitaille, MS PA-C Reviewed 05/2023
 


BASICS

DESCRIPTION

  • A non-IgE mediated immune reaction to gliadin, a protein component of dietary gluten (found in wheat, barley, rye, and other grains) primarily affecting the small intestine in geneti...

DIAGNOSIS

HISTORY

  • Diarrhea and cramping are the most common GI symptoms.

  • Other symptoms include: Steatorrhea (fatty stools); abdominal pain or distension; nausea, vomiting, flatulence; weight loss, weak...

TREATMENT

GENERAL MEASURES

  • Gluten-free diet (GFD)—avoid wheat, barley, rye, and other grains that contain gluten

    • Rice, corn, and nut flour are safe and palatable substitutes  (2).

    • Grains: uncontaminated ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Consultation with registered dietitian

  • Screen for osteoporosis and treat accordingly.

  • Follow-up with GI at 3 to 6 months for serology and 12 months for repeat biops...

REFERENCES

1
Boettcher E, Crowe SE. Dietary proteins and functional gastrointestinal disorders. Am J Gastoenterol. 2013:108(5):728–736. doi10.1038/aja.2013.97
2
Husby S, Murray JA, Katzka DA. AGA clinica...

ADDITIONAL READING

  • Husby S, Koletzko S, Korponay-Szabo I, et al. European Society of Paediatric Gastroenterology, Hepatology, and Nutrition guidelines for diagnosing celiac disease 2020. J ...

SEE ALSO

Algorithms: Diarrhea, Chronic; Malabsorption Syndrome 

CODES

ICD10

K90.0 Celiac disease 

SNOMED

  • 396331005 Celiac disease (disorder)

  • 61715008 Celiac disease with diffuse intestinal ulceration

CLINICAL PEARLS

  • Screen for celiac disease in patients with nonspecific GI symptoms, presumed IBS, dermatitis herpetiformis, unexplained transaminitis, or unexplained iron deficiency anemia.

  • Test total ...

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