Definition
A
malabsoprtion state in the small bowel in which villous atrophy
occurs due to an intolerance to alphagliadin within the wheat
protein, gluten.
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Radiographic Appearance
On a barium follow through
examination there is Dilatation of the jejunum, reduced mucosal folds
in jejunum and increased mucosal folds in the ileum.
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Pathology
In a Coeliac, gluten damages the lining of the small intestine which
greatly reduces the ability of the gut to absorb adequate nutrients
from food. Wasting can occur, leading to severe illness resembling
malnutrition
Coeliac patients may be acutely and severely ill with weight loss,
vomiting and diarrhoea or they may have chronic almost trivial
symptoms such as tiredness, lethargy and breathlessness. Usual
symptoms would be somewhere between these extremes. Adults may have
a history of abdominal or intestinal upsets, or they may suddenly
develop the condition at any time. Amaemia, abdominal discomfort,
mouth ulcers and weight loss are common features. A Coeliac baby
would be fit and well until after the introduction of
gluten-containing solids. Then the baby would develop typical pale,
bulky, offensive-smelling stools, become miserable and lethargic and
generally fail to thrive. All the symptoms described can be
characteristic of other medical conditions, so people should not
jump to conclusions but should seek proper medical advice. They
should not treat themselves with a gluten-free diet before seeking
medical help. Some people are diagnosed as Coeliac without having
obvious symptoms. For example, the condition may be picked up when
relatives of a Coeliac are being studied. |
Treatment:
The only treatment necessary to return the intestine to normal is a
strict gluten-free diet. Sometimes vitamin or mineral supplements
may be required to start with. The hospital consultant will know
from tests what the patient needs, and supplements should NOT be
taken without medical supervision. To avoid serious complications of
the condition, a strict gluten-free diet is necessary for life. |
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http://www.anatomie1.med.uni-erlangen.de |
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Useful Link: http://www.coeliac.co.uk
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