Quotes
We have presented excerpts from lectures taken at various forums by Dr. Pankaj Vohra who is a Senior Consultant, Pediatric Gastroenterology at Max Healthcare, Delhi and is the Founder of Celiac India & Beyond Foundation.
- ‘Celiac disease has such a varied presentation that all disciplines must be aware about it as the patient can present to any specialist.’
- ‘With increasing awareness, the gap between onset of symptoms and diagnosis is decreasing but any child with recurrent diarrhea must be screened for celiac disease.’
- ‘Failure to thrive could be due to celiac disease. This is one more reason why growth charts must be meticulously maintained for every child.
- ‘With rising incidence of celiac disease in our country, it would be prudent to at least screen a patient for celiac disease before labelling it as Irritable bowel syndrome.’
- In the absence of any blood loss, recurrence of iron deficiency anemia must make us consider the diagnosis of celiac disease.’
- ‘10% of previously undiagnosed cases of cirrhosis can now be attributed to celiac disease. Hence, every patient with any undiagnosed liver disease must be tested for the same.’
- ‘Almost 20% of all cases of short stature presenting to the endocrinologist are due to celiac disease.’
- Any patient with a gastrointestinal symptom that does not seem to resolve with standard medications should be considered to have a food allergy or intolerance.’
- ‘Several patients with type 1 diabetes have celiac serology but a normal intestinal biopsy and hence, are potential celiacs. They need close follow-up but this is a good example where two autoimmune conditions co-exist.’
- ‘Vitamin D is mostly absorbed from the upper gastrointestinal tract which is the area where the maximum damage occurs’.
- ‘Vitamin D deficiency is very common but if it does not resolve with oral administration of Vitamin D, celiac disease should be considered.’
- ‘Intussusception is a surgical emergency usually seen in infancy and young children. However in recurrent and small bowel intussusceptions, celiac disease must be considered and ruled out.’
- ‘Rare in Indian population, dermatitis herpetiformis is one of the only conditions associated with celiac disease where the intestinal biopsy may be normal in up to 10-20% of individuals.’
- ‘Unusual yes but now many experts believe that 5% of all celiac disease patients can present with constipation. This means that if there is hard to treat constipation or constipation is associated with any other feature e.g. growth failure, celiac disease screening is recommended.’
- ‘During the screening process, IgA deficiency must be ruled out or else false negative screening might occur.’
- ‘Celiac disease can rarely occur in the absence of tTG antibody even though IgA levels are normal. These patients need close follow up.’
- ‘Celiac disease is being reported in obese individuals as well. In western countries, about 5-20% of all patients with celiac disease are obese!’
Read Symptoms to know more about how celiac disease presents itself.