There is a great article about celiac disease featured in the most recent issue of the Journal of the American Academy of Physicians Assistants. The article is meant to be a teaching piece about the basics of celiac disease, common symptoms, diagnosis and treatment. It looks at two case studies to highlight important information about the misdiagnosis of the disease.
The most interesting part of the article perhaps is at the very beginning where the authors outline "Teaching Points." They differ from other teaching articles about celiac in that they right away point out key messages for medical professionals. Many articles start with the basics of the disease, but here, the information jumps right to important messages that are often overlooked. Here are the teaching points from the article:
- Instead of having diarrhea, many patients with celiac disease may be asymptomatic or report atypical GI complaints such as constipation, abdominal pain, or lactose intolerance.
- A substantial number of patients with celiac disease initially receive a diagnosis of irritable bowel syndrome.
- Most patients with celiac disease never receive a diagnosis.
- Complications associated with celiac disease include iron deficiency anemia, osteoporosis, and a modest increase in the risk of GI cancers and non-Hodgkin's lymphoma.
- All diagnostic testing should be performed while the patient remains on a gluten-containing diet.
- Treatment for celiac disease can alleviate symptoms, reverse nutritional deficiencies, improve bone mineral density, and minimize the risk of associated malignancy.
