John Damianos, M.D. Profile picture
@MayoClinicGIHep Gastroenterology & Hepatology Fellow. Yale Internal Medicine, Dartmouth Med. Microbiome, probiotics, brain-gut, diet, motility, IBD, MedEd 🇬🇷

Oct 23, 2022, 19 tweets

Defining #celiac disease and non-celiac gluten (more accurately, wheat) sensitivity

#Celiac disease is common

#Celiac associations

Most #celiac disease patients have "atypical" symptoms

Rarely can present with acute severe abdominal pain from intussusception or bowel edema

Pathogenesis of #celiac disease: T-cell mediated

💡Lots of potential treatment targets!

Diagnostics
🧬start with anti-TTG IgA

💡For serology and biopsy, need to be eating gluten to avoid false negative

Caveats with #celiac serology

Endoscopy in #celiac disease

Histology of #celiac disease

Villous blunting is NOT specific to #celiac disease! (This is why we need serology)

Do we need a biopsy to diagnose #celiac disease? Not necessarily...

HLA DQ2/DQ8

💡NOT diagnostic, since up to 40% of healthy population has; good for EXCLUDING #celiac disease

Diagnosing #celiac disease when already on a gluten-free diet

Management of #celiac disease: gluten-free diet

🦴osteopenia/osteoporosis
🧫cancer
☠️mortality

Disease monitoring

What about ongoing symptoms on a strict gluten-free diet?

#Celiac disease summary

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