THE IMPORTANCE OF DIAGNOSIS AND DIET THERAPY IN CELIAC DISEASE

Author: Miklos Andreea DorianaCoordinator:

Lecturer dr. Fárr Ana-Maria

• Celiac disease is a condition that affects a large percentage of the population. The studies estimate that the incidence of the disease in Romania is about 2%

• It is characterized by the atrophy of the villi of the small intestine by an autoimmune mechanism induced by the consumption of gluten.

• Gluten is a general name for the proteins found in wheat, rye and barley. The toxic component of gluten that causes the disease is gliadin.

• This disease can appear in childhood or later, even in adulthood

• In Romania celiac disease falls among the category of underdiagnosed diseases

Symptoms• Adults are less likely to have digestive symptoms, with only

one-third experiencing diarrhea. Adults are more likely to have:

▫ iron-deficiency anemia refractory to treatment▫ bone loss or osteoporosis▫ dermatitis herpetiformis Duhring

• Digestive symptoms are more common in infants and children. Here are the most common symptoms found in children:

▫ abdominal bloating and pain▫ chronic diarrhea followed by malabsorption▫ delayed growth due to nutritional deficiencies.▫ iron-deficiency anemia

DIAGNOSING CELIAC DISEASE

• There are two steps in diagnosing celiac disease: serological tests to identify specific antibodies (anti-transglutaminase, anti-gliadin, anti-endomysial) and endoscopic biopsy.

• Patients must NOT be on a gluten-free diet when performing diagnostic tests.

• There are quick tests that can be made by the patient or laboratory determinations-ELISA

Treatment

• A healthy and gluten free diet is the most important thing, and the only treatment for a patient with celiac disease who needs to follow the diet for lifetime.

• The patients should be more informed about their new diet and their new lifestyle they have to follow.

Objective

• We wanted to see if the disease is correctly diagnosed and to put the emphasis on the importance of the diet.

Material and method

• We researched the records of Pathological Anatomy Department from Emergency County Hospital Tîrgu Mureș between 2010-2014 to find out the incidence of the disease and the number of correctly diagnosed cases based on the histopathological diagnosis.

Results

25% confirmed cases after the duodenal

biopsy

75% unconfirmed cases after the

histopathological diagnosis

135 Patients

Confirmed cases 25 %Unconfirmed cases 75 %

Gender distribution

Children 3%

Men 42 %

Women 58 %

0 15 30 45 60 75

All patients

All patients

Age distribution for confirmed cases

Children 1%

Men 8%

Women 16%

0 8 15 23 30

Age 20-50Age +50

Conclusions

• Out of all investigated cases it was a small percent of confirmed diagnosis, only 25%.

• The study shows that there is need to pay more attention for this disease to be diagnosed in a greater extent.

• After diagnosis, the patients should meet with a dietitian-nutritionist!

• Gluten-free diet is required.

• Medication for this disease does not exist!!