Coeliac Disease Overview

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Questions and Answers

What is a common symptom of gastro-oesophageal reflux disease (GORD)?

Burning chest pain (correct)

Weight loss

Excessive salivation

Dizziness upon standing

Which factor is NOT associated with the pathogenesis of GORD?

Increased abdominal pressure

Poor oesophageal clearance

Dysfunctional lower oesophageal sphincter

Obstruction of the portal vein (correct)

What indicates life-threatening bleeding from oesophageal varices?

Frequent hiccups

Light headedness

Vomiting of bright red blood (correct)

Severe abdominal pain

Which of the following is a possible management option for bleeding oesophageal varices?

Variceal band ligation Signup and view all the answers

Which lifestyle modification is recommended for patients with oesophageal varices?

Weight loss Signup and view all the answers

What is a primary complication associated with oesophageal varices?

Life-threatening bleeding Signup and view all the answers

Which condition is characterized by the inflammation of the oesophagus due to stomach acid?

Gastroesophageal reflux disease Signup and view all the answers

What is Barrett’s oesophagus primarily a risk factor for?

Oesophageal cancer Signup and view all the answers

Which symptom is most commonly associated with peptic ulcer disease?

Abdominal pain Signup and view all the answers

What is the primary underlying cause of coeliac disease?

Autoimmune reaction to gluten Signup and view all the answers

What part of the gastrointestinal tract does the oesophagus connect?

Pharynx to stomach Signup and view all the answers

Which of these factors is associated with an increased prevalence of oesophageal varices?

Liver cirrhosis Signup and view all the answers

What is the main function of the lower oesophageal sphincter?

To prevent reflux of stomach contents Signup and view all the answers

What is a primary result of gliadin peptide absorption in individuals with coeliac disease?

Immune response leading to villi atrophy Signup and view all the answers

Which manifestation is associated with untreated coeliac disease?

Osteoporosis and neurological disorders Signup and view all the answers

What is a critical intervention upon diagnosis of coeliac disease?

Complete removal of gluten from the diet Signup and view all the answers

What is observed during an endoscopy of an individual with coeliac disease?

Granular appearance of duodenal folds and loss of villi Signup and view all the answers

Which condition poses an increased risk for T cell lymphoma when unmanaged?

Coeliac disease Signup and view all the answers

How does coeliac disease primarily affect nutrient absorption?

Significally decreases absorption due to villi damage Signup and view all the answers

What unusual items are known to unexpectedly contain gluten?

Processed meats and certain condiments Signup and view all the answers

During the inflammatory reaction in coeliac disease, which immune cells are primarily involved?

T cells Signup and view all the answers

Study Notes

Coeliac Disease

People with coeliac disease are reactive to the gliadin in gluten.
The large gliadin peptides are normally absorbed by enterocytes and do not cause any problems.
In coeliac disease, the gliadin peptides enter the lamina propria of the small intestine and initiate an immune response.
A T cell mediated autoimmune inflammatory reaction results in marked atrophy or total loss of villi.
There is a granular appearance of duodenal folds and a loss of villi in coeliac disease.
Severe symptoms can cause anemia due to severe malabsorption.
Malabsorption can also result in major vitamin deficiencies, causing neurological conditions, osteopenia, and severe metabolic disturbances.
Untreated coeliac disease increases the risk for T cell lymphoma.
Gluten needs to be totally removed from the diet.
Even trace amounts can cause changes to the gastrointestinal mucosa.
Increased risk of T cell lymphoma with non-compliance.
Foods that most people don’t realize contain gluten: beer, stock cubes, chewing gum, some lollies, icecream, processed meats, tomato sauce and other condiments, hot chips etc.

Oesophageal Varices

Enlarged veins in the oesophagus.
These can be diagnosed via endoscopy.
Life-threatening complication of portal hypertension.
Seen in up to 50% of patients with liver disease such as liver cirrhosis.
25-40% of sufferers will experience bleeding. 15% of these will die from blood loss.
There are no symptoms until they rupture.
Signs of bleeding can include vomiting of blood, dark or tarry stools.
Signs of blood loss: lightheadedness, confusion, loss of consciousness.
Caused by obstructed blood flow through the portal vein.
Cirrhosis of the liver can result in portal hypertension, where blood flow is backed up.
Increased pressure causes veins of the esophagus to become dilated and swollen.
Lifestyle modifications: weight loss, stopping all alcohol.
Medication to lower blood pressure: beta blockers.
Surgery: variceal band ligation.

Gastro-oesophageal Reflux Disease (GORD)

Gastroesophageal reflux disease (GORD/GERD) is when stomach acid or bile is not contained within the stomach and repeatedly flows back into the oesophagus.
Prevalence: 10-20% of the population in Western countries.
Common in people aged 40+.
Symptoms: Heartburn, pain often worse after eating, when lying down, and with emotional stress.
Regurgitation of sour-tasting gastric content.
Nausea, burping.
Dry cough and sore throat.
Poor oesophageal clearance: efficient peristalsis and saliva production limits the exposure of the oesophagus to the acid and bile in the stomach.
Dysfunctional lower oesophageal sphincter (LOS): The LOS relaxes to allow the passage of food into the stomach and closes to protect the oesophagus from the acid in the stomach.
Alcohol and smoking, obesity, pregnancy, smoking.

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Description

This quiz explores the pathophysiology of coeliac disease, including the immune response to gliadin, effects of malabsorption, and the importance of a strict gluten-free diet. Understand the potential complications of untreated coeliac disease, such as anemia and increased lymphoma risk. Test your knowledge on the key concepts related to this autoimmune condition.