A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye) [pallor] [due topossible sequelae: edema (water retention in the tissues)]. Abdomen (abdomen) Shape of the abdomen? … Celiac Disease: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count to exclude iron deficiency anemia [microcytic hypochromic anemia: MCV↓ → microcytic MCH ↓ → hypochromic] Ferritin (iron storage protein) [ferritin ↓] Alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), gamma-glutamyl transferase (γ-GT, gamma-GT; GGT) [in up to 50% of cases: elevated transaminases]. Detection of … Celiac Disease: Test and Diagnosis
Therapy goals Complaint-free life Avoidance of complications and secondary diseases Therapy recommendations The most important therapy for celiac disease (gluten-induced enteropathy) is avoidance of gluten-containing foods. However, this does not bring a cure in about 10 percent of those affected. Asymptomatic celiac patients also benefit from a gluten-free diet. Asymptomatic celiac patients are defined as … Celiac Disease: Drug Therapy
Optional medical device diagnostics – depending on the results of the medical history, physical examination, laboratory diagnostics, etc. – for differential diagnostic workup Esophago-gastro-duodenoscopy (EGD; examination method of the upper part of the digestive tract: esophagus-gastro-duodenum) with collection of small intestinal biopsies* * (small intestinal suction biopsy; collection of at least six biopsies from different … Celiac Disease: Diagnostic Tests
As part of micronutrient therapy (vital nutrients) for gluten-induced enteropathy, particular attention should be paid to the substitution of critical vital nutrients (micronutrients). Critical nutrients and vital substances (macro- and micronutrients) Fat-soluble vitamins vitamins A, D, E, K Fat-soluble carotenoid beta-carotene Vitamin B9 folic acid Vitamin B12 Vitamin C Calcium Magnesium Sodium Potassium Chloride Iron … Celiac Disease: Micronutrient Therapy
Medical history (history of illness) represents an important component in the diagnosis of celiac disease (gluten-induced enteropathy). Family history Are there any diseases of the gastrointestinal tract in your family that are common? Are there any hereditary diseases in your family? Social anamnesis Current medical history/systemic medical history (somatic and psychological complaints). Do you suffer … Celiac Disease: Medical History
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, … Celiac Disease: Or something else? Differential Diagnosis
Dietary therapy consists of the consistent elimination of foods containing gluten. Thus, foods made from or containing wheat, rye, barley, and oats must be avoided. Furthermore, the treatment should include the reduced absorption of vital substances (micronutrients) caused by damage to the intestinal villi and mucosa of the small intestine. Gluten is contained as a … Celiac Disease: Nutrition Therapy
The following are the most important diseases or complications that may be contributed to by celiac disease (gluten-induced enteropathy): Eyes and eye appendages (H00-H59). Nyctalopia (night blindness) due to vitamin A deficiency. Blood, blood-forming organs – immune system (D50-D90). Iron deficiency anemia (microcytic anemia; anemia due to iron deficiency). Folic acid deficiency Certain conditions originating … Celiac Disease: Complications
To prevent celiac disease (gluten-induced enteropathy), attention must be paid to reducing individual risk factors.Behavioral risk factors Diet Consumption of foods containing gluten Prevention factors (protective factors) Genetic factors: Genetic risk reduction depending on gene polymorphisms: Genes/SNPs (single nucleotide polymorphism): Gene: HLA-DQA1 SNP: rs2187668 in the gene HLA-DQA1 Allele constellation: GG (0.3-fold). Breastfeeding (questionable protective … Celiac Disease: Prevention
First symptoms may develop shortly after the introduction of complementary food! The classic symptoms (diarrhea and failure to thrive) show, however, only about 20% of sufferers. Consequential diseases in later (small) childhood often lead to the diagnosis. Note: Screening examinations in children show that 50 to 70 % of those affected are symptom-free [2. 3]. … Celiac Disease: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Celiac disease is a chronic autoimmune disease of the mucosa of the small intestine. Celiac disease is based on a genetic predisposition with the presence of the HLA traits DQ2 and DQ8. Almost all celiac disease patients (99%) carry the HLA traits HLA-DQ2, DQ8 or DQ7. Only these HLA molecules can … Celiac Disease: Causes
