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Abdominal distension in a 4 year old

Serological testing should be offered to children with both gastrointestinal and non-gastrointestinal symptoms. 1 2 3 4 Non-gastrointestinal symptoms that should prompt investigation for coeliac disease include dermatitis herpetiformis, dental enamel defects, low mineral density, osteoporosis, incre...

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Bibliographic Details
Published in:BMJ 2011-08, Vol.343 (aug03 3), p.d3614-d3614
Main Authors: Kesavelu, Dhanasekhar, Dalzell, Mark, Eaton, Vicki
Format: Article
Language:English
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Summary:Serological testing should be offered to children with both gastrointestinal and non-gastrointestinal symptoms. 1 2 3 4 Non-gastrointestinal symptoms that should prompt investigation for coeliac disease include dermatitis herpetiformis, dental enamel defects, low mineral density, osteoporosis, increased incidence of bone fractures, and short stature. 1 2 An observational study found that in 8-10% cases of short stature, coeliac disease was the underlying cause. 5 3 How would you confirm the diagnosis? Short answer After the diagnosis is confirmed, coeliac disease is managed with complete adherence to a gluten free diet. [...]this point, children should remain on a gluten containing diet. Long answer Once coeliac disease is confirmed, it is managed with strict adherence to a gluten free diet. [...]this point, gluten should remain in the diet so that the patient can have an intestinal biopsy and a histological diagnosis can be made. Overall the long term outcome is good with dietary management and regular monitoring. 1 2 However, undiagnosed or untreated coeliac disease is associated with numerous long term complications, including poor growth, delayed puberty, dental problems, osteoporosis, and increased risk of cancers such as non-Hodgkin's lymphoma and small bowel cancer. 2 Further studies are needed to assess the effects of long term adherence to a gluten free diet on these complications.
ISSN:0959-8138
1468-5833
1756-1833
DOI:10.1136/bmj.d3614