Conference Report | Coeliac Disease Next, Dr Luisa Mearin, from the Leiden
University Medical Centre, Netherlands, spoke on Infant Feeding Practices and Coeliac Disease, and highlighted the project she is currently involved in – PREVENTCD. The project, studying the influence of dietary history in the prevention of CD, involves 10 European countries and a total of 1000 children, with children and mothers being followed over one to three years. The projects objective is to reduce the number of people suffering from CD in Europe. See
www.preventceliacdisease.com for more information. Dr
Tim Card, ‘gluten sensitivity’. Stating, at present, we don’t
know the real differences between CD and gluten sensitivity (GS), Professor Sanders showed delegates ‘A Model for the relationship between coeliac disease, IBS and gluten sensitivity’.2
The model highlighted
that you can have IBS symptoms and CD, and you can also have IBS symptoms and GS but both can also present with no IBS symptoms! Professor Sanders also referred to an interesting study, which looked at gluten causing GI symptoms in subjects without CD, suggesting that non-coeliac gluten intolerance may exist.3
The area of GS is very from the University of
Nottingham, then stepped up to the podium to present on Misdiagnosis as Irritable Bowel Syndrome; how often is coeliac disease overlooked? Dr Card provided a great insight into the problem of patients being diagnosed with irritable bowel syndrome when they actually have CD. He referred to the General Practice Research Database (GPRD), and explained that data analysed between 1987 and Oct 2010 revealed that 14 per cent of patients diagnosed with CD had previously been given a diagnosis of IBS by their GP. The Spectrum of Gluten Sensitivity was then
discussed by Professor David Sanders, Royal Hallamshire Hospital, Sheffield. Professor Sanders commenced his presentation by sharing some relatively new concepts surrounding CD, such as: • The average age of presentation is between 40 and 60 years old
• •
References: 1. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease (2012). J Pediatr Gastroenterol Nutr.; 54(1): 136-60. 2. Ball A, Hadjivassiliou M, Sanders DS (2010). Is gluten sensitivity a "No Man's Land" or a "Fertile Crescent" for research?Am J Gastroenterol.; 105: 222-3. 3. Biesiekierski JR, et al (2011). Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. Am J Gastroenterol.; 106(3): 508-14.
For every nine adults diagnosed with CD only one child is
For every one adult diagnosed with CD, seven cases are not recognised
• Adults with undiagnosed CD tend to have a normal BMI or may be overweight. Along with highlighting that the prevalence of
CD is increasing, and that we now have better screening and diagnostic techniques, Professor Sanders went on to discuss the very topical area of
CN CN
i
interesting and further research is warranted so we can understand the differences between GS and CD. Sharing best practice and her own experiences,
Shirley James, GI Advanced Nurse Practitioner Nurse Independent/Supplementary Prescriber from the Southampton University Hospital, spoke with much enthusiasm on An Innovative Approach to the Management of Adults with Coeliac Disease. Sister James shared her experience of developing a GI database and care pathway, which has helped improve the management of CD patients following a review of their service in 2008. The review found that it was taking three to six months for newly diagnosed CD patients to be seen in a non-specialist dietetic clinic and patients were often never seen by a GI Nurse Specialist. In 2009, a joint clinic was formed, run by a specialist nurse and specialist gastroenterology dietitian.
Results from
an audit in 2010 (ongoing) showed that over 61 per cent of newly diagnosed patients had been seen within four weeks of diagnosis. This innovative approach to the management of adults with CD has not only benefited patients but streamlined their service, resulting in time and cost savings. This conference, organised by Coeliac UK,
provided delegates with much to think about with regards to CD diagnosis, prevention and current practice. The event was kindly sponsored by Dr Schär, Nairn’s Gluten Free and Juvela.
NEW from
nutrition2me.com... Resource Centre Useful Links • Case Studies • CN Article Index • Guidelines • Free to View Articles
NEW
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47