Celiac Disease: Or something else? Differential Diagnosis

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Hyperthyroidism (hyperthyroidism).
  • Food allergy or food intolerance
    • FOODMAP intolerance: abbreviation for “fermentable oligo-, di- and monosaccharides and polyols” (engl. “fermentable oligosaccharides (fructans and galactans), disaccharides (lactose) and monosaccharides (fructose) (AND) as well as polyols” (= sugar alcohols, such as maltitol, sorbitol, etc. )); FODMAP‘s are e.g. wheat, rye, garlic, onion, milk, honey, apple, pear, mushrooms, salicylate; fermentation produces gases and the binding of water can have a laxative effect. Note: According to a study, a slower bread preparation in traditional bakery ensures that the components in the bread that cause discomfort are already degraded by the time it is baked.
    • Fructose intolerance
    • Gluten sensitivity (non-celiac disease-nonwheat allergy-nonwheat sensitivity) – non-allergic and non-autoimmune condition in which consumption of gluten can lead to celiac disease-like symptoms;
      • Time to onset of symptoms: variable, hours to days.
      • Clinical picture: abdominal pain (abdominal pain), meteorism (flatulence), diarrhea (diarrhea)/nausea(nausea), possibly also headache, foggy mind (foggy senses), fatigue, myalgia (muscle pain), exanthema (skin rashes) and neurological symptomsDiagnosis; at least six weeks of gluten-containing normal diet, then another six weeks of gluten-free diet;
        • No improvement in symptoms: a gluten sensitivity can be excluded.
        • Regression of symptoms: a double-blind placebo-controlled provocation test is required to confirm the diagnosis:
          • Gluten-free diet and 8 mg of gluten in a capsule or placebo daily for one week; after a one-week washout period, placebo or gluten again for another week in a crossover design (same subjects given the test drug and the control drug sequentially).Positive test: reduction of symptoms by at least 30 percent under placebo– compared with gluten provocation.
      • Laboratory diagnostics: determination of gliadin antibodies; skin test: no.
    • Histamine intolerance
    • Lactose intolerance
    • Protein intolerance (eg cow’s milk, soy).
    • Wheat allergy – time to onset of symptoms: hours to days; determination of wheat IgE; skin test.
    • Wheat sensitivity (synonym: nonceliac gluten sensitivity, NCGS) – time to onset of symptoms: variable, hours to days; symptoms may be intestinal (“affecting the intestine”) and extraintestinal (“outside the intestine”); gliadin antibodies: negative; IgE antibodies positive; skin test: no. Cause of wheat sensitivity are amylase trypsin inhibitors (ATIs), which are found in wheat, barley and rye; a gluten-free diet leads at the same time to an avoidance of ATIs and thus in about 90% of cases to a disappearance of symptoms.rnährung leads at the same time to an avoidance of ATIs and thus in about 90% of cases to a disappearance of symptoms.

Cardiovascular system (I00-I99).

  • Myocardial infarction (heart attack)

Infectious and parasitic diseases (A00-B99).

Liver, gallbladder and bile ducts – pancreas (pancreas) (K70-K77; K80-K87).

Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93).

  • AIDS enteropathy – intestinal disease based on AIDS.
  • Appendicitis (inflammation of the appendix)
  • Autoimmune enteropathy – autoimmune bowel disease.
  • Colitis indeterminata – disease that is a combination of ulcerative colitis and Crohn’s disease.
  • Ulcerative colitis – inflammatory bowel disease (IBD).
  • Diversion colitis – disease occurring after surgical immobilization of intestinal segments.
  • Diverticulitis – inflammation of diverticula (protrusions of mucosa through muscle gaps in the intestinal wall).
  • Infectious colitis – inflammation of the intestine caused by bacteria (such as salmonella), viruses or parasites.
  • Ischemic colitis – inflammation of the intestine due to undersupply of the intestine with nutrients and oxygen.
  • Microscopic colitis or microscopic colitis (synonyms: collagenous colitis; collagen colitis, collagen colitis) – chronic, somewhat atypical inflammation of the mucosa of the colon (large intestine), the cause of which is unclear and which is clinically accompanied by violent watery diarrhea/4-5 times daily, also at night; some patients suffer from abdominal pain (abdominal pain) in addition; 75-80% are women/females > 50 years of age; correct diagnosis is only possible with colonoscopy (colonoscopy) and step biopsies (taking tissue samples in the individual sections of the colon), i.e. i.e. by a histological (fine tissue) examination to put.
  • Crohn’s diseasechronic inflammatory bowel disease (CED); usually runs in relapses and can affect the entire digestive tract; characteristic is the segmental affection of the intestinal mucosa (intestinal mucosa), that is, it may be affected several intestinal sections, which are separated from each other by healthy sections.
  • Whipple’s disease (synonyms: Whipple’s disease, intestinal lipodystrophy; English : Whipplés disease) – rare systemic infectious disease; caused by the gram-positive rod bacterium Tropheryma whippelii (from the group of actinomycetes), which can affect various other organ systems in addition to the obligately affected intestinal system and is a chronic recurrent disease; symptoms: Fever, arthralgia (joint pain), brain dysfunction, weight loss, diarrhea (diarrhea), abdominal pain (abdominal pain), and more.
  • Irritable bowel syndrome (colon irritable) – high prevalence (disease frequency) of almost 40% (95% confidence interval: 27-50%) for the simultaneous presence of irritable bowel syndrome in patients with celiac disease.
  • Rectal ulcer (rectal ulcer).
  • Radiation colitis – inflammation of the large intestine, which can occur after radiation, especially in the context of cancer therapy.
  • Ulcus duodeni (duodenal ulcer).
  • Ulcus ventriculi (gastric ulcer)

Musculoskeletal system and connective tissue (M00-M99)

  • Behçet’s disease (synonym: Adamantiades-Behçet’s disease; Behçet’s disease; Behçet’s aphthae) – multisystem disease of the rheumatic type associated with recurrent, chronic vasculitis (vascular inflammation) of the small and large arteries and mucosal inflammation; The triad (the occurrence of three symptoms) of aphthae (painful, erosive mucosal lesions) in the mouth and aphthous genital ulcers (ulcers in the genital region), as well as uveitis (inflammation of the middle eye skin, which consists of the choroid (choroid), the ray body (corpus ciliare) and the iris) is stated as typical for the disease; a defect in cellular immunity is suspected

Neoplasms – tumor diseases (C00-D48).

  • Familial adenomatous polyposis (FAP; synonym: Familial polyposis) – is an autosomal dominant inherited disorder. This leads to the occurrence of a large number (> 100 to thousands) of colorectal adenomas (polyps). The probability of malignant (malignant) degeneration is almost 100% (average from the age of 40).
  • Colon carcinoma (colon cancer)
  • Lymphoma – malignant disease originating in the lymphatic system.

Pregnancy, childbirth and puerperium (O00-O99).

  • Extrauterine pregnancy – pregnancy outside the uterus; extrauterine pregnancy is present in approximately 1% to 2% of all pregnancies: Tubalgravidity (ectopic pregnancy), Ovariangravidity (pregnancy in the ovary), Peritonealgravidity or Abdominalgravidity (pregnancy in the abdominal cavity), Cervicalgravidity (pregnancy in the cervix).

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).

  • Adnexitis – inflammation of the so-called adnexa (engl. : appendages).
  • Ureteral stones (ureteral stones)

Injuries, poisonings, and other consequences of external causes (S00-T98).

  • Mechanical injuries, unspecified
  • Radiation enteritis – inflammation of the intestine caused by irradiation (radiotherapy) to the abdomen (stomach)or pelvis due to a tumor condition

Medication

  • Olmesartan (angiotension II receptor antagonists; are among the antihypertensive/blood pressure-lowering drugs) → celiac disease-like enteropathy (bowel disease) with diarrhea (diarrhea) with or without nausea, vomiting, and weight loss