Gastro: Coeliac Disease: Free MSRA Podcast

⚕️FREE MSRA PODCAST –Coeliac Disease🎧 A clear, high-yield breakdown of this autoimmune gluten-triggeredenteropathy – perfect for exam prepand real-life clinical scenarios. 🧠Key Learning Points📌Definition• Coeliac Disease isa chronic autoimmune condition triggeredby gluten, where ingestion leads to immune-mediated damage of the smallintestinal lining, resulting in malabsorptionand systemic complications.📌Causes & RiskFactors• Geneticpredisposition: HLA-DQ2 (95%), HLA-DQ8 (80%)• Environmentaltrigger: gluten ingestion• Family history(1st-degree relatives)• Associatedautoimmune diseases: Type 1 diabetes,autoimmune thyroid disease• Genetic syndromes:Down’s syndrome, Turner’s syndrome🧠Mnemonic: “GAF-T” – Gluten, Autoimmune, Family, Trisomies/Turner📌Pathophysiology• Gluten ingestion →abnormal immune response → villous atrophy• Key antibodies: anti-TTG (IgA), EMA,deamidated gliadin peptide (DGP)• Leads to reduced nutrient absorption• Inflammatory andimmune-mediated damage driven by T-cells📌Symptoms• Diarrhoea,bloating, abdominal pain• Fatigue• Iron-deficiencyanaemia• Weight loss• Dermatitisherpetiformis• Neurologicalsymptoms: tingling, ataxia• In children:faltering growth, delayed puberty🧠Mnemonic: “DIGEST-FATIN” – Diarrhoea, Iron-deficiency, GI symptoms, Energylow, Stomach pain, Tiredness, Faltering growth, Anaemia, Tingling, Neurology📌DifferentialDiagnosis• Inflammatory BowelDisease (Crohn’s, UC)• IBS• Lactoseintolerance• Non-coeliac glutensensitivity• Tropical sprue• Intestinalinfections📌Diagnosis• Serology: Anti-TTG (IgA), EMA – first-line• Check total IgAlevels – if deficient, use IgG-based tests(e.g. IgG-DGP)• Small bowel biopsy (duodenum): confirms villous atrophy, crypthyperplasia, intraepithelial lymphocytes• HLA-DQ2/DQ8 testing: useful to exclude diagnosis• Biopsy-freediagnosis possible in some adults with strong serology🧠Tip: Must remain on a gluten-containing diet untilbiopsy is done📌Management• Lifelong strict gluten-free diet – cornerstoneof treatment• Support from dietitians and patientgroups (e.g. Coeliac UK)• Nutritionalsupplements (iron, folate, calcium, vitamin D) as needed• Monitor forcomplications and dietary adherence• Annual review:symptom check, bloods (FBC, LFTs, vitamins), consider DEXA scan• Refractory CoeliacDisease → specialist referral ± immunosuppressive therapy📌Complications• Nutritionaldeficiencies (iron, folate, B12, vitamin D)• Osteoporosis, osteomalacia• Infertility• Increased risk of GI malignancies (e.g.enteropathy-associated T-cell lymphoma)• Neurological symptoms, splenic dysfunction,dermatitis herpetiformis🧠Mnemonic: “BONES CAN FAIL” – Bones (osteoporosis), Cancer, Anaemia,Neurology, Endocrine, Skin/Spleen📌Prognosis• Excellent withstrict gluten-free diet – symptoms resolve and gut heals• Risk ofcomplications is significantly reduced with good adherence• Non-adherenceleads to ongoing symptoms, nutritional deficits, and increased malignancy risk 📎More MSRA Resourcesfor Coeliac Disease📝Revision Notes: https://www.passthemsra.com/topic/coeliac-disease-revision-notes/🧠Flashcards: https://www.passthemsra.com/topic/coeliac-disease-flashcards/💬Accordion Q&ANotes: https://www.passthemsra.com/topic/coeliac-disease-accordion-qa-notes/🚀Rapid Quiz: https://www.passthemsra.com/topic/coeliac-disease-rapid-quiz/🎓Full Course: https://www.passthemsra.com/courses/gastroenterology-for-the-msra/ Hashtags#MSRA #MSRARevision#MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQ&ANotes#MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision#MSRARevisionWebsite #CoeliacDisease