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Celiac Disease

Zachariah John Kamla, DO and Lloyd A. Runser, MD, MPH, FAAFP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • An immune-mediated reaction to dietary gluten (found in wheat, barley, rye) primarily affecting the small intestine in genetically predisposed individuals

  • Presentations

    • Typical

      • Diarrhea...

DIAGNOSIS

HISTORY

  • Diarrhea, cramping are the most common GI symptoms.

  • Steatorrhea (fatty stools)

  • Abdominal pain or distension

  • Nausea, vomiting, flatulence

  • Weight loss, weakness, fatigue

  • Delayed puberty

  • Iron ...

TREATMENT

GENERAL MEASURES

  • GFD.

    • Rice, corn, and nut flour are safe and palatable substitutes (1)[C].

    • Grains: uncontaminated oats, rice, corn, tapioca, quinoa, amaranth, sorghum

  • Levels of IgA antigliadin n...

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
Rubio-Tapia A, Hill ID, Kelly CP, et al; for American College of Gastroenterology. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol.  2013;108(5...

ADDITIONAL READING

  • Green PH, Lebwohl B, Greywoode R. Celiac disease. J Allergy Clin Immunol.  2015;135(5):1099–1106. [View Abstract on OvidMedline]

  • Husby S, Koletzko S, Korponay-Szabó IR, et al; f...

CODES

ICD10

K90.0 Celiac disease 

ICD9

579.0 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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