the patient celiac

What are medical students learning about Celiac Disease these days?

0 comments October 09, 2013

I've been wondering this for a while. I graduated from medical school 10 years ago, which makes me a relatively "young" doctor.  Although I did learn about Celiac Disease during my medical training, the image that I had burned in my mind was of a sickly child with a huge belly, diarrhea, and failure to thrive.  I do not recall seeing a single adult patient with it during my clinical years of medical school, outside of a patient with Celiac who came to one of our genetics lectures to share her experiences.  I vividly remember thinking that her gluten free life sounded horrible (sad, but true!)

Although I now work in a community hospital, I have a teaching appointment at a large, well-respected medical school which allows me to be able to interact with and teach medical students on occasion.  I recently worked with an exceptionally smart and motivated student who hung out with me for a day. Just for fun, at the end of our day together, I asked if she had ever heard of Celiac Disease.  She told me that she had learned about Celiac Disease during her pre-clinical years (first and second year).  I gave her a short quiz on what she had learned about Celiac Disease. Here are her answers:

What is Celiac Disease?  An autoimmune disease where the body produces an antibody to gluten and is unable to digest gluten.  Exposure to gluten leads to characteristic GI symptoms of bloating and diarrhea, and is also associated in some cases with dermatitis herpetiformis.

How is Celiac Disease diagnosed? Testing for the presence of TTG antibodies.

Have you seen a patient with Celiac Disease? If so, what were his or her symptoms?  Yes, it was a man with bloating, diarrhea, weight loss, and a rash of the upper extremities.

What is your best estimate as to the prevalence of Celiac Disease?  1 in 100,000

I thought that her answers were okay until I read the 1 in 100,000! Although these are the answers of only one medical student, who is only half way through her medical schooling, my impression is that students are still learning that Celiac Disease is a rare disease associated with digestive and skin symptoms only. I really hope that I am wrong, and I will report back as I further investigate this topic.

Are any of you in medical or nursing school right now? If so, would you be willing to share what you have actually learned about Celiac Disease in your lectures?


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