The management of adults with coeliac disease in primary care

Primary Care Society for Gastroenterology


Introduction

  • Coeliac disease is a chronic, permanent and if untreated, potentially life-threatening condition. In coeliac disease, the mucosa of the small intestine is damaged by gluten, a protein found in wheat, rye and barley. A similar protein in oats may cause damage in people with severe sensitivity to gluten
  • The damage to the small intestine results in the reduced ability to digest and absorb food and causes malabsorption of essential nutrients such as vitamins, iron, folic acid and calcium

Key facts about coeliac disease

  • As many as one in 100 people in the UK have positive coeliac serology; the clinical significance of this is unclear
  • Coeliac disease is under diagnosed in the UK
  • The only treatment for coeliac disease is a strict, life-long gluten-free diet. Effective management therefore relies on regular follow-up of patients to ensure strict adherence
  • Untreated coeliac disease often results in unnecessary morbidity including:
    • faltering growth in childhood
    • anaemia
    • osteopenia
    • osteoporosis
    • infertility
    • possible increase in the rare small bowel lymphoma and adenocarcinoma

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