The Curbsiders Internal Medicine Podcast REBOOT #300 Celiac Disease with Dr. Amy Oxentenko
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Nov 6, 2023 Celiac Disease with Dr. Amy Oxentenko features Dr. Amy Oxentenko, Chair of Medicine at Mayo Clinic AZ. The podcast discusses recognizing both classic and non-classical features of celiac disease, diagnostic testing, management, and proper patient follow-up. The episode also covers non-celiac gluten sensitivity and considerations for atypical celiac patients. Dr. Oxentenko provides valuable insights while keeping the conversation engaging and informative.
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Celiac Presents Beyond Classic Diarrhea
- Up to 20% of celiac patients present with constipation, not diarrhea, and many can be obese.
- Celiac disease manifests diversely, so keep a low threshold for testing beyond classic symptoms.
How to Explain Celiac to Patients
- Explain that celiac is an autoimmune condition triggered by gluten in genetically susceptible individuals, not a typical food allergy.
- Emphasize chronic inflammation causing intestinal and systemic issues, with variable symptoms among patients.
Celiac Serology Testing Best Practices
- Use IgA tissue transglutaminase antibody as the primary screening test and avoid ordering multiple serologic tests to reduce false positives.
- Reserve additional testing for equivocal cases or serology-biopsy discrepancies.