Video report: Diagnosing extraintestinal celiac disease
Dr. Julio C. Bai, Departeamento de Medicina, Hospital de Gastroenterologia, Dr. Carlos Bonorino Udaond, Buenos Aires, Argentinia
Alongside the fact that the disease often has a subclinical course, one of the main reasons why celiac disease is regularly diagnosed so late is the manifestation of extraintestinal symptoms. These symptoms include refractory anaemia, reflux disease, skin conditions like dermatitis herpetiformis and psoriasis, osteopenia and osteoporosis as well as recurrent mouth ulcers, neurological symptoms and a low body weight.
Celiac disease is strongly associated with autoimmune diseases. There is a very clear link with dermatitis herpetiformis, an autoimmune disease that causes wheals and blisters. A gluten-free diet will usually clear up the extraintestinal symptoms associated with celiac disease. Within just a few weeks, sufferers can expect to see an improvement in reflux symptoms, psychological abnormalities and gluten ataxia as well as a reduced risk of fractures caused by osteoporosis. Neurological symptoms and osteoporosis, however, take a very long time to improve. Realistically, sufferers will only see progress after following a strict gluten-free diet for some years.
Video report of the presentation given by Dr. Julio C. Bai, Buenos Aires, at the Falk Symposium 193 “Celiac disease and other small bowel disorders”, September 5 – 6, 2014 in Amsterdam.
© Falk Foundation e.V., Freiburg. Alle Rechte vorbehalten.
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Walters TD et al, Gastroenterology. 2014;146(2):383–91
In children newly diagnosed with severe Crohn’s disease, early monotherapy with an anti-TNF-alpha-antibody produced better overall clinical and growth outcomes at 1 year than early monotherapy with an immunomodulator.
Osterman MT et al, Gastroenterology. 2014;146(4):941–9
In patients with Crohn’s disease, the incidence of malignancy with adalimumab monotherapy was not greater than that of the general population. However, co-administration of an immunomodulator and adalimumab was associated with an increased risk of non-melanoma skin cancer and other cancers.
Kabbani TA et al, Am J Gastroenterol. 2014;109(5):741–6
The authors have developed an easy and useful diagnostic algorithm to differentiate celiac disease from non-celiac gluten sensitivity.
van Gerven NMF et al, J Hepatol. 2013;58(1):141–7
Loss of remission or relapse occurs in virtually all patients with autoimmune hepatitis in long-term remission when immunosuppressive therapy is discontinued.
Feld JJ et al, N Engl J Med. 2014;370(17):1594–603
In previously untreated patients with hepatitis C virus genotype 1 infection and no cirrhosis, a 12-week multitargeted regimen of ABT-450/r + ombitasvir + dasabuvir + ribavirin was highly effective.
Zeuzem S et al, N Engl J Med. 2014;370(17):1604–14
Rates of response to a 12-week interferon-free combination regimen (ABT-450/r + ombitasvir + dasabuvir + ribavirin) were more than 95% among previously treated patients with hepatitis C virus genotype 1 infection, including patients with a prior null response.
Leggett CL et al, Clin Gastroenterol Hepatol. 2014;12(4):583–8
Obstructive sleep apnea is associated with an increased risk of Barrett’s esophagus, potentially through body mass index and gastroesophageal reflux disease-independent mechanisms.
Coleman HG et al, Am J Gastroenterol. 2014;109(4):527–34
Patients with long-segment Barrett’s esophagus or Barrett’s ulcer have an increased risk of progressing to high-grade dysplasia/esophageal adenocarcinoma. The absence of reflux symptoms is not associated with a reduced risk of malignant progression.
Dellon ES et al, Clin Gastroenterol Hepatol. 2014;12(4):589–96
Eosinophilic esophagitis is frequently diagnosed in the United States, with an estimated prevalence of 57/100,000 persons.
Oskarsson V et al, Clin Gastroenterol Hepatol. 2014;12(4):676–82
Diets with high glycemic load are associated with an increased risk of non-gallstone-related acute pancreatitis.
Current Falk literature:
Falk Symposium report
Celiac Disease and Other Disorders of the Small Bowel
Amsterdam (The Netherlands), September 5 – 6, 2014
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