Understanding Celiac Disease From Genetics to the Future Diagnostic Strategies

Celiac disease (CD) is an autoimmune disorder characterized by the permanent inflammation of the small bowel, triggered by the ingestion of gluten. It is associated with a number of symptoms, the most common being gastrointestinal. The prevalence of this illness worldwide is 1%. One of the main problems of CD is its difficulty to be diagnosed due to the various presentations of the disease. Besides, in many cases, CD is asymptomatic. Celiac disease is a multifactorial disease, HLA-DQ2 and HLA-DQ8 haplotypes are predisposition factors. Nowadays, molecular markers are being studied as diagnostic tools. In this review, we explore CD from its basic concept, manifestations, types, current and future methods of diagnosis, and associated disorders. Before addressing the therapeutic approaches, we also provide a brief overview of CD genetics and treatment.

Summary of the causative and treatment factors of diarrhea and the use of a diarrhea assessment and treatment tool to improve patient outcomes

This article is a review of the causative factors and pharmacologic treatments of diarrhea. This information was incorporated into a Diarrhea Assessment and Treatment Tool (DATT) to guide clinicians on comprehensive diarrhea assessment and current treatment recommendations. The tool was utilized at a university-affiliated oncology institution by a clinical nurse specialist on 26 patients as a performance improvement project. Ease of use and efficacy of DATT were tested. Eighty-one percent of patients were assessed using DATT in 30 minutes or less. Seventy-nine percent of the 57 identified diarrhea classifications were not being treated upon initial assessment. Diarrhea control was achieved in 73% of the patients within 7 days or fewer when DATT was utilized. The premise of diarrhea management is that if all the causative factors are not treated, diarrhea will persist. The conclusions are that this tool will aid the clinician in a comprehensive assessment of diarrhea and provide a systematic approach to diarrhea treatment. The need for research on best practice for management of the various causative factors of diarrhea is needed.