CC: 6 weeks diarrhea
Investigations:
Upper endoscopy
Diagnosis: Celiac disease.
Differential diagnosis:
1. Lactose intolerance
2. Inflammatory bowel disease
3. Irritable bowel disease
4. Chronic pancreatitis
5. Microscopic colitis
6. Bacterial overgrowth
Check Glucose
Investigations:
Upper endoscope
Management: What will you do ?
Gluten free diet
Avoid barley, rye, oats and wheat ( BROW )
Can eat rice, corn, maize, buckwheat, potato and soybean
Refer to Dietician
Refer to GI
Do BMD scan
Check and treat for iron, B12 and folate and vitamin D
Vaccines like flu, pneumococcal, meningococcal, Haemophilus ( due to hyposplenism
Refer to Psych ( if coexist depression, anxiety )
Complications:
Osteoporosis
T-cell lymphoma
Vitamins ADEK deficienc
Jejunal ulceration
Adenocarcinoma of small bowel
Follow up ( monitoring ) :
