HCPLive Network

Assessment, Diagnosis, and Management of Celiac Disease

 
A diet free of gluten remains the standard treatment for celiac disease and related conditions, according to a medical researcher who spoke this week at a joint conference of the American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy in Coronado, California.
 
Celiac disease is an immune disorder in the small intestine caused by dietary gluten. Symptoms of the chronic digestive condition include abdominal pain and diarrhea. Celiac disease is roughly four times more prevalent now than 50 years ago, said Sheila Crowe, MD, professor of medicine and director of research, Division of Gastroenterology, at the University of California, San Diego. The reason is unknown but may be related to increased use of wheat (which is a gluten source) in diets worldwide, she said.
 
The classic picture of the disease as a child with malabsorption is changing to include more and more middle-age adults. Many of Crowe’s patients are women with children, she said.
 
Biopsies are the gold standard for disease diagnosis, though they can in some cases produce false positive or false negative results, Crowe said. Studies show that as the number of biopsies increase so do the number of diagnoses, so Crowe cautioned physicians not to overdo it. She said she usually conducts no more than six biopsies on a patient, but no less than four.


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More Reading
Atherosclerotic internal carotid artery disease is a major contributor to ischemic stroke. Surgeons use a combination of carotid artery and brain imaging to determine if patients have symptomatic carotid stenosis. However, there remains widespread disagreement on the threshold, timing, and best technical approach to carotid revascularization in symptomatic patients.