Canada: FMPE CME on Celiac Disease (2005)

[aklap]

Canada - The Foundation for Medical Practic Education.

CME - Celiac Disase - May 2005

http://www.fmpe.org/en/documents/topics/celiacdisease.pdf
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Al

“We cannot all do great things, but we can do small things with great love.” Mother Teresa

[Linda]

Thanks Al.

I thought this was interesting (from page 3):
Celiac Disease is a lifelong condition. However clinical remission may occur during the second decade of life. This "remission" may be permanent or symptoms may recur decades later. Occasionally, other diseases may mimic celiac disease so diagnostic confirmation is essential.

(I thought Celiac mimicked other diseases, not the other way around. I guess I also thought that the idea of "remission" was hogwash. I mean, as soon as you're on the diet, aren't your intestines in "remission"? The disease never goes away. Are they implying that merely the symptoms go away?)

and from page 7: (a debate for/against mass screening)
treating patients with apparently silent celiac disease can be problematic since a lifelong, gluten-free diet is complex, expensive, socially disruptive, and has not yet been shown to protect these patients from the development of complications.

and from page 9:
The treatment of asymptomatic, "silent" celiac disease is controversial. It may be helpful to discuss the uncertainty regarding the benefits of a gluten-free diet in asymptomatic people versus the possibility of developing complications if celiac disease is left untreated.

(With regards to the patient on page 9 (and I guess page 7), it doesn't say anything about a biopsy, so I guess I'm confused as to whether they diagnosed her with Celiac or not, because I thought the whole point was that if you have asymptomatic/silent cd then consuming gluten is like smoking...you can't see anything happening on the outside, but damage is taking place on the inside. Also interesting that they know the diet is "socially disruptive", and it seems that's why they aren't always recommending it, even though villous atrophy/malabsorption, etc. seems to be a complication...but dammit, Al, I'm not a doctor, I'm a mother.)
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Mom of Ty (he's eight) who was diagnosed by bloodwork June 2005, biopsy August 11, 2005, notified on & started GF August 18, 2005

[aklap]