Coeliac disease. An increasing problem? Myrtle Walsh Dietitian. Prevalence. Recent studies suggest 1% population have positive coeliac serology. 2003 study in England – 1.2% Also shown that 0.5 – 1% of Europe, S. America,U.S.A., Australasia may have undetected coeliac disease
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An increasing problem?
Study by HIN et al, in primary care, patients presenting with TATT and anaemia
Vasquez et al – x3 increase in fracture risk
West et al – small increased risk
Suggested all coeliac patients should have DEXA screening for osteoporosis
More studies required? before universally recommended
[note there will be changes to these products to comply with Codex Alimentaris]
A dietary problem?
Current treatment, following diagnosis, may combine:
use of medication, eg antidiarrhoeal, smooth muscle relaxants
exploring dietary triggers, dietary manipulation
strategies to cope with stress, reassurance, and where appropriate, drug treatment for anxiety and depression
Burden S J Hum Nut, vol14
Wald  lists dietary modification as an essential element
Require patient to be motivated/appropriate, can cause financial and family burden. It is very intensive.
Patient presents with eg. Loose stools + abdominal pain, suffered on and off - 6 mths
Eliminate organic causes/Rome 11 criteria
Investigate other causes further : Diagnose IBS
Treat symptoms [GI/psych] : Explore dietary intervention
Referral for dietetic advice