The Cribsiders S5 Ep105: Reflux, Celiac, & Constipation: Rapid Review (Fables from the Cribside!)
Mar 13, 2024
The podcast touches on pediatric GI disorders like constipation, reflux, and celiac disease. It discusses the nuances of infant reflux, management of reflux in children, symptoms and management of celiac disease, monitoring celiac patients, practical tips for constipation, and specialized treatment strategies for constipation in patients with neurodivergent conditions.
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Serologic Diagnosis of Celiac Disease
- Tissue transglutaminase IgA (TTG IgA) testing is 95% sensitive and specific for celiac but requires normal total IgA.
- European guidelines sometimes allow serologic diagnosis without endoscopy when TTG exceeds 10 times normal.
Endoscopy Timing in Celiac Diagnosis
- Ensure patients undergo endoscopy for celiac diagnosis while still consuming gluten to avoid false negative biopsies.
- Biopsies focus on the duodenal bulb area during upper endoscopy for diagnosis.
Risks of Untreated Active Celiac
- Persistent active celiac disease risks poor growth, bone fractures, and small bowel malignancies like lymphoma.
- Symptoms like frequent bone fractures and growth faltering should raise suspicion for celiac.