Auteur Topic: Nieuwe richtlijnen mei 2009 - Coeliakie in Engeland met tabellen etc.  (gelezen 2784 keer)


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Onder dit persbericht de volledige inhoud artikel nieuwe richtlijnen Coeliakie in Engeland.

NICE guideline to improve the recognition and assessment of coeliac disease
The National Institute for Health and Clinical Excellence (NICE) has today (27 May 2009) issued a guideline to improve the recognition and diagnosis of coeliac disease. Coeliac disease is a condition in which the immune system in a person’s intestine (gut) reacts to a protein called gluten. The immune reaction makes part of the gut inflamed, which can make it difficult for the person to absorb nutrients from their food. Coeliac disease can cause a wide range of symptoms in the digestive system (such as indigestion, diarrhoea or constipation) and in the rest of the body (such as tiredness, weight loss and bone thinning).

The disease is believed to be present in up to 1 in 100 of the population, although only about 10–15% of people with the condition are clinically diagnosed. Many of the remainder may be well, but many will have chronic problems such as lethargy, or gastrointestinal symptoms - these can result in chronic ill health and often extensive medical investigation without a definite diagnosis. For the first time, the guideline provides a clear set of symptoms, signs, and types of presentation or conditions that should alert healthcare professionals to consider the presence of coeliac disease, and sets out a pathway of investigation when making the diagnosis.

Key recommendations include:

Offer serological testing to children and adults with any of the following signs, symptoms and conditions:Signs and symptoms

- Chronic or intermittent diarrhoea

- Failure to thrive or faltering growth (in children)

- Persistent or unexplained gastrointestinal symptoms including nausea and vomiting

- Prolonged fatigue

- Recurrent abdominal pain, cramping or distension

- Sudden or unexplained weight loss

- Unexplained iron-deficiency anaemia


- Type 1 diabetes

- Autoimmune thyroid disease

- A skin disorder called dermatitis herpetiformis

- Irritable bowel syndrome

- Close relatives (parents, children or brothers and sisters) with coeliac disease

Before serological testing inform people (and their parents and carers as appropriate) that
- testing is accurate only if they follow a gluten-containing diet
- when following a gluten-containing diet, they should eat some gluten in more than one meal every day for at least 6 weeks before testing
- they should not start a gluten-free diet until diagnosis is confirmed by intestinal biopsy Inform people (and their parents or carers as appropriate) that a delayed diagnosis of coeliac can result in:
- continuing ill-health
- long-term complications, including osteoporosis and increased fracture risk
- growth failure, delayed puberty and dental problems (in children)Dr Fergus Macbeth, Director of the Centre for Clinical Practice at NICE says: “For the first time this guideline provides healthcare professionals with a tool to help diagnose and manage coeliac disease, based upon the best available evidence. Providing clarity to healthcare professionals will enable them to provide better support to people with coeliac disease which in turn will give them more confidence to cope with living with the condition.”

+ de rest van dit persbericht:

De Engelse richtlijnen met o.a.:
Table 1 Presenting features of people with coeliac disease
Table 2 Coexisting conditions and coeliac disease

Volledig artikel (richtlijnen) - totaal 86 pagina's:
2009/032 NICE guideline 26 May 2009

Groeten, Ine