Celiac Disease (Gluten Enteropathy) (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Bhupinder Anand, MD
In this Article
What is the treatment for celiac disease?
The only treatment for celiac disease and the inflammation of the small intestine caused by gluten protein exposure is a life-long gluten free diet.
What is latent celiac disease, and how is it treated?
Latent or potential celiac disease describes those people suspected of having the disease with a positive antibody blood test, but whose small bowel biopsy is normal. Currently, there is no indication to begin treatment with a gluten free diet, however, repeat biopsy might be considered if signs and symptoms develop or if symptoms of malabsorption are present.
What is silent celiac disease, and how is it treated?
Individuals may be screened for celiac disease and have both a positive antibody blood test and a positive small intestine biopsy, and yet have no symptoms. This is considered silent celiac disease and the recommendation is to perform further testing looking for malabsorption complications such as anemia and osteoporosis. A gluten free diet may be indicated if these tests are positive.
What is refractory celiac disease, and how is it treated?
While a gluten free diet tends to resolve symptoms in most individuals, in a small group of patients, the gluten free diet fails to control the symptoms including abdominal pain and malabsorption. These patients are considered refractory to diet treatment. It is important that other types of bowel disease, including Crohn's disease are first excluded before making this diagnosis. If diet therapy fails to resolve symptoms, refractory celiac disease is often treated with the same medications used in other autoimmune disorders to decrease inflammation. These medications include corticosteroids (prednisone), azathioprine (Imuarn, Azasan) and cyclosporine.
What are the complications of celiac disease?
The inability to properly absorb vitamins, minerals and nutrients from the diet can affect many organs in the body. Since the diagnosis of celiac disease is often delayed, there can be significant issues with iron deficiency anemia, osteoporosis because of decreased levels of calcium and vitamin D, and poor growth and development.
Aside from the other associated autoimmune disorders that might also be present, celiac disease is associated with an increased incidence of lymphoma and small intestine cancer. This risk is reduced in patients who maintain a strict gluten free diet.
Medically Reviewed by a Doctor on 2/10/2015
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