Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

New Nhs Nice Coeliac Guidelines To Uk Drs


georgie

Recommended Posts

georgie Enthusiast

Recognition and assessment of coeliac disease

NHS NICE Coeliac Guidelines to UK Drs

Clinical guidelines CG86

Issued: May 2009

How reliable are serological tests compared with intestinal biopsy in detecting early coeliac disease?

− Evidence of the presence of coeliac disease can be suggested by the finding of highly specific and sensitive antibodies to tissue transglutaminase and to endomysium. Confirmation of the presence of intestinal damage revealed by the histological examination of small-intestinal biopsies remains the traditional method of making the diagnosis. The sensitivity of this investigation has rarely, if ever, been formally investigated. With increased use of serological tests for coeliac disease it has become evident that some people with positive coeliac autoantibodies have apparently normal small-intestinal histology. Some such people are, nonetheless, symptomatic and have gluten-sensitive malabsorption. Early detection of coeliac disease may be important to prevent long-term complications, Therefore longitudinal studies are needed to determine whether serological markers are superior and can reliably detect early coeliac disease before intestinal damage occurs.

Open Original Shared Link

This is a quick flow chart from the Quick Reference Guide

Does the person have any symptoms in Box A or B

Yes

Is the person on a Gluten containing diet

No

Is the person willing/able to reintroduce Gluten to their diet ?

No

Refer them to a Gastro Specialist and inform them that it may be difficult to confirm a diagnosis on intestinal biopsy , and that this may have implications on their ability to access prescribed gluten-free foods

Box A

Offer serological testing to children and adults with any of the following signs , symptoms and conditions.

Chronic or intermittant diarrhoea

Failure to thrive or faltering growth ( in children)

Prolonged Fatigue ( "tired all the time" )

Recurrent abdominal pain , cramping or distention

Unexplained iron anaemia or other unspecified anaemia

Conditions

Autoimmune Thyroid Disease

Dermititis Herpetiformis

Irritable Bowel Syndrome

Type 1 Diabetes

First degree relatives ( parents, siblings or children ) with Coeliac Disease

Box B

Consider offering serological testing to children and adults with any of the following

Addisons Disease

amenorrhoea

apthous stomatitis ( mouth ulcers)

autoimmune liver conditions

autoimmune myocarditis

chronic Thombocytopenia

dental enamel defects

depression or bipolar disorder

downs syndrome

epilepsy

low trauma fracture

lymphoma

metabolic bone disease

microscopic colitis

persistant or unexplained constipation

persistantly raised liver enzymes with unknown cause

polyneuropathy

recurrent miscarriage

reduced bone mineral density

sarcoidosis

Sjogren's syndrome

Turner syndrome

unexplained alopecia

unexplained subfertility


Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):



Celiac.com Sponsor (A8-M):



Archived

This topic is now archived and is closed to further replies.


  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      127,879
    • Most Online (within 30 mins)
      7,748

    JwH6281
    Newest Member
    JwH6281
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      121k
    • Total Posts
      70.5k

  • Celiac.com Sponsor (A22):





  • Celiac.com Sponsor (A21):



  • Upcoming Events

  • Posts

    • Bebee
      I have been diagnosed with Microscopic Colitis (LC) for quite a few years, so I have been gluten-free and DF.  I would like to get tested for Celiac Disease because of the possibility of cross contamination and colon cancer.  And if you were hospitalized and didn't have a celiac diagnosis you could not get gluten-free food, I don't know if that is true or not.  Also because there is chance of colon cancer so I want to know if I have Celiac Disease and need to be on very restrictive diet.  The only testing I did was a sigmoid scope and Enter Lab but no gene testing.  I know I can go back to eating gluten for a few months, but I would worry you would have to stay home for the few months while getting gluten.  What other options do I have?  Should I do the gene testing?  Maybe through Entero Lab?  Any other tests?  How important is it to have Celiac diagnosed? Thank you! Barb
    • trents
      Take it easy! I was just prompting you for some clarification.  In the distillation process, the liquid is boiled and the vapor descends up a tube and condenses into another container as it cools. What people are saying is that the gluten molecules are too large and heavy to travel up with the vapor and so get left behind in the original liquid solution. Therefore, the condensate should be free of gluten, no matter if there was gluten in the original solution. The explanation contained in the second sentence I quoted from your post would not seem to square with the physics of the distillation process. Unless, that is, I misunderstood what you were trying to explain.
    • Mynx
      No they do not contradict each other. Just like frying oil can be cross contaminated even though the oil doesn't contain the luten protein. The same is the same for a distilled vinegar or spirit which originally came from a gluten source. Just because you don't understand, doesn't mean you can tell me that my sentences contradict each other. Do you have a PhD in biochemistry or friends that do and access to a lab?  If not, saying you don't understand is one thing anything else can be dangerous to others. 
    • Mynx
      The reason that it triggers your dermatitis herpetiformis but not your celiac disease is because you aren't completely intolerant to gluten. The celiac and dermatitis herpetiformis genes are both on the same chronometer. Dermatitis herpetoformus reacts to gluten even if there's a small amount of cross contamination while celiac gene may be able to tolerate a some gluten or cross contamination. It just depends on the sensitivity of the gene. 
    • trents
      @Mynx, you say, "The reason this is believed is because the gluten protein molecule is too big to pass through the distillation process. Unfortunately, the liquid ie vinegar is cross contaminated because the gluten protein had been in the liquid prior to distillation process." I guess I misunderstand what you are trying to say but the statements in those two sentences seem to contradict one another.
×
×
  • Create New...