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Review article: coeliac disease and its management
1Department of Gastroenterology, The Rayne Institute, St Thomas' Hospital, London, UK.
Alimentary Pharmacology & Therapeutics
|January 20, 1999
Summary
Coeliac disease (CD) is an autoimmune disorder triggered by gluten, affecting the small intestine. Early diagnosis and a strict gluten-free diet are crucial for managing symptoms and preventing serious complications like osteoporosis and lymphoma.
Area of Science:
- Gastroenterology
- Immunology
- Genetics
Background:
- Coeliac disease (CD) is an autoimmune small intestinal disorder.
- It is characterized by villous atrophy, triggered by dietary gluten in genetically susceptible individuals.
- The immunological mechanisms are still under investigation.
Purpose of the Study:
- To review the clinical presentations, associated conditions, and complications of coeliac disease.
- To highlight the importance of early diagnosis and gluten withdrawal.
- To emphasize lifelong monitoring for coeliac disease patients.
Main Methods:
- Review of clinical presentations and associated conditions.
- Population screening using anti-endomysial antibodies.
- Analysis of disease prevalence and complications.
Main Results:
- Coeliac disease presents with a wide range of clinical manifestations, including 'silent' and 'latent' forms.
- Population screening reveals a higher prevalence than clinically apparent cases.
- Common complications include osteopenia, osteoporosis, and an increased risk of lymphoma.
Conclusions:
- A strict gluten-free diet is essential for managing coeliac disease and preventing complications.
- Lifelong follow-up is necessary for prompt investigation of new symptoms and abnormalities.
- Earlier diagnosis and gluten withdrawal improve outcomes.