Condition Info - BotMed Application

ConditionName

Celiac disease (Gluten intolerance)

ConditionDescription

Symptoms

Diarrhea: paleness; looseness; and bulkiness of stool within 3-6 mo of dietary onset; 
Dermatitis herpetiformis 10%

Children: Bloating; Abnormal stool;
Look for time of bread products introduction. 
Peak frequency 9-18 mo.

Adults: Diarrhea; Steatorrhea; Weigh loss;

Acid reflux;
Abdominal pain;
Joint pain;
Anal itching;

PhysicalFindings

Children: Failure to thrive; abdominal distention, lethargy, irritability, anorectic, muscle wasting.

ClinicalTests

CBC, iron study
Anti-tissue transglutaminase AB – best initial 90% sensitive and 95% specific
Anti-endomysial AB - 90% sensitive and 95% specific

Radiography.  
Most accurate:  histology small bowel biopsy (flattening of villi), can help to r/o lymphoma

IgA antigliadin AB – not in use

Clinical perl: Also order TTG IgG, TTG IgA, not only IgA.

RiskFactors

First-degree relatives of patients with celiac disease;
Autoimmune thyroiditis;
Type 1 diabetes;
Autoimmune liver disease;
Down syndrome;
Selective immunoglobulin A (IgA) deficiency;
Turner syndrome;
Williams syndrome;
Juvenile chronic arthritis;

IsRedFlag

IsNPLEX

Consequence

B12 Deficiency;
Folate Deficiency;
Iron Deficiency;
Anemia;
Defects in dental enamel;
Osteoporosis;
Infertility;

Children:
Failure to thrive;
Delayed growth and development;
Delayed onset of puberty;
Short stature;

ProgressionFromCondition

TreatmentOptions

Avoid gluten;
TCM: dump heat;

PharmOptions

WebLink

https://www.merckmanuals.com/en-ca/professional/gastrointestinal-disorders/malabsorption-syndromes/celiac-disease