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Celiac Disease

Lloyd A. Runser, MD, MPH, FAAFP and Radoslava Djigrova Reviewed 06/2020
 


BASICS

DESCRIPTION

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

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

  • Gluten-free diet (GFD)—avoid wheat, barley, and rye.

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

    • Grains: uncontaminated oats, rice, corn, tapioca, quin...

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

  • DeGeorge KC, Frye JW, Stein KM. et al. Celiac disease and gluten sensitivity. Prim Care.  2017;44(4):693–707.

  • Lebwohl B, Sanders DS, Green PHR. Coeliac disease. Lancet.  20...

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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