To Study Prevalence of Celiac Disease in Chronic Diarrhoea Patients in North India Region

Abstract

Celiac disease (CD) is a disorder of an inflammatory T-cell response to the proteins called “gluten” and characterized by the presence of typical auto antibodies and histological alterations of the small bowel mucosa. It is a common but frequently unrecognized disease. To study the prevalence of celiac disease in chronic diarrhoea patients in north India region and study the effects of gluten free diet in these patients clinically, serologically and by histopathology of endoscopic biopsy tissue. Total 120 cases were selected who having diarrhea of more than two weeks duration were enrolled in the study. All the patients having clinical suspicion would be subjected to following special investigations beside the routine investigations like stool examination done for pH, presence of fecal reducing substances (Benedict's test), occult blood (Benzidine test), microscopy and cultured. Anti - IgA TTG antibodies were assessed by indirect solid Phase immunometric assay (ELISA). Patients with positive anti-IgA tTG, whose parents provided consent, underwent upper GI endoscopy under topical anesthesia. Four biopsies were taken from the second portion of the duodenum and histopathological grading done according to a modification of the Marsh classification. The prevalence of celiac disease is upcoming in our country also and it is around 10% in this study of chronic diarrhoea. In the country like ours where endoscopic biopsy not easily available in remote hospitals, patients with high index of clinical suspicion and higher Anti tTG titer must be subjected for the gluten free diet.

Keywords: Celiac disease, Chronic diarrhoea, Gluten