Talk:Coeliac disease/Archive 6

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Screening - USPSTF

doi:10.1001/jama.2016.10395 and doi:10.1001/jama.2017.1462 JFW | T@lk 20:29, 28 March 2017 (UTC)

Symptoms in the box

I have updated and adjusted the symptoms in the infobox. Chronic diarrhea and malabsorption (classic symptoms) are currently the exception rather than the rule. Non-classic presentation currently predominate, with a wide variety of symptoms that can affect any organ or tissue of the body; digestive symptoms are usually mild, intermittent or even absent.

I have used two references already present on the page and added a 2016 reference from World Gastroenterology Organisation Global Guidelines [1].

I hope the result is good.

Best regards. --BallenaBlanca (Talk) 21:25, 23 April 2017 (UTC)

The infobox is to contain lists of items not full sentence / prose.

We say "few symptoms" is one of the possibilities. Just because classic symptoms are not always present does not mean we should exclude them.

How about we simple start the list with "no symptoms" and then list the classic one?Doc James (talk · contribs · email) 04:10, 24 April 2017 (UTC)

The WGO says "The prevalence of nonclassic celiac disease is high in the Western world, with patients mainly presenting with unexplained iron-deficiency anemia." so added that aswell[2] Doc James (talk · contribs · email) 04:20, 24 April 2017 (UTC)

Ah! Sorry! I fear that I'm not acquainted with infoboxes. Is there any reference guide on infoboxes?

We have to choose the list of symptoms better. Now you've improved it, but chronic diarrhea would be one of the last to put on a long, long... list, because is exceptional and other symptoms are currently predominant.

Within complications, anemia is a possibility, but there are many more.

How many symptoms can be put? How long can listings be? And, for example, can we put in an infobox "extra-intestinal symptoms"? Or "several autoimmune diseases"?

As you know, the most important concern on CD is that continue to dominate the old ideas about the disease, which make it diagnosis and recognizing so difficult, leading about 80-90% of cases currently remain undiagnosed.

Best regards. --BallenaBlanca (Talk) 11:44, 24 April 2017 (UTC)

We want no more than about half a dozen symptoms. Having classic ones there is still important. We do not want those cases to be missed either. They are at least a starting point.

Both the WGO and the NIH mention classic before non classic.[3][4]Doc James (talk · contribs · email) 14:38, 24 April 2017 (UTC)

Would "None or non-specific" work for you? Doc James (talk · contribs · email) 14:42, 24 April 2017 (UTC)

Chronic diarrhea is the symptom that is easy to identify (although many of these diagnoses are later lost due to errors in the diagnostic protocol ...) Also, many health professionals still think that chronic diarrhea is an ever-present symptom and if there is no diarrhea, they rule out celiac disease. But diarrhea can be sporadic, intermittent, alternating with constipation, or there may be no diarrhea, or only constipation (up to 50% of cases) or only mild and even absent digestive symptoms... Most people with non-classic symptoms do not even have the opportunity to be evaluated, because specialists do not think they may be celiac. People with non-classical symptoms are the hidden part of the "celiac iceberg", the vast majority. If I had to choose, I prefer 90% of diagnoses compared to the current 10%, although obviously the goal is for everyone to get a diagnosis... ;)

When talking about the symptoms, it does not matter if one speaks first of the classics and then of the non-classics, as long as it is clear that the classics are less frequent. In a well-explained text, that's no problem. In the infobox list, adding to the start "None or non-specific" you have solved it acceptably. :)

It is difficult to trim down the list of symptoms. As for diarrhea, it is preferable to put "diarrhoea" instead of "chronic diarrhoea", which is more global. I propose this list with at least these symptoms, supported by the same refs you have used. Is it too long?

None or non-specific, abdominal pain, diarrhoea, constipation, abdominal distention, malabsorption, weight loss, short stature, tiredness, bone or joint pain, paresthesias, mood changes, depression, anxiety, headaches, seizures, dermatitis, dental enamel defects

I have edited the complications, adding "osteoporosis, infertility, cancer, ataxia". I believe that there can be no objection, they are perfectly recognized and accepted (but not the only ones...), and again, supported by the same refs you used. My question is, can we write in the infobox terms like "autoimmune diseases", "neurological disorders"...?

Best regards. --BallenaBlanca (Talk) 08:14, 25 April 2017 (UTC)

Have changed "chronic diarrhea" to "diarrhea". Yes the list you propose is too long. This are all under the none specific group "tiredness, bone or joint pain, paresthesias, mood changes, depression, anxiety, headaches, seizures, dermatitis, dental enamel defects" Doc James (talk · contribs · email) 18:36, 25 April 2017 (UTC)

Thanks!

The current format of the infobox can be very useful and informative, but the opposite can also happen. It is the drawback of the closed lists.

We know that many people will just take a look at the top of the page. We have to put ourselves in the mind of the profane readers: they read about a disease that has traditionally been considered only digestive, but in fact is multi-systemic. They read in the box "Specialty: Gastroenterology". Then read a list of symptoms, all of them digestive. The readers will not know that "non-specific" refers to symptoms that can affect any organ of the body, because everything seen at a glance relates only to digestive symptoms. You and I understand what "non-specific" means, but a profane person (or a health professional unfamiliar with current knowledge about celiac disease) will not understand.

The infobox has to be able to give a global and adjusted vision, but at the moment only transmits: "it is a digestive disease".

We have to find a way to clarify it. It is the most important thing we have to convey about the symptoms. Otherwise, we will continue to be unable to progress and unable to provide current and reliable information.

I have take a look at other infoboxes on other pages and I understand that we can, without undue prose, make an explanation.

Also, I miss two important symptoms. Since diarrhea is mentioned, we can not let go of constipation. And dermatitis herpetiformis is not non-specific, since it only appears in celiacs. I will now add them, I think you'll agree, I think there can be no objection.

I will wait your proposals to solve the issue of extradigestive symptoms.

Best regards. --BallenaBlanca (Talk) 20:23, 25 April 2017 (UTC)

The first two symptoms listed are NOT gastrointestinal (ie none and non specific). Dermatitis herpetiformis is not very common in celiacs but sure. Doc James (talk · contribs · email) 20:28, 25 April 2017 (UTC)

Thanks for trying to balance this Infobox. DH is relatively common but is well recognized unlike some of the other conditions. Please consider if we should keep cancer, infertility and ataxia which are rare. Can we include "other autoimmune disorders" in complications?Jrfw51 (talk) 13:06, 26 April 2017 (UTC)

I repeat that neither the lay readers nor the "outdated" health professionals will be able to understand what "non-specific" means. Non-specific symptoms can refer to both digestive or non-digestive symptoms. And as the list that follows are only digestive symptoms, it is confusing, because it seems to be a development of the above. The fact that the symptoms may be "nonspecific" or general does not mean that they should not be mentioned. Following the same reasoning, we should delete or not list the symptoms of many infoboxes, because they appear in many other diseases.

In fact, let's look at what the WGO guideline says (page 13): "In nonclassic celiac disease, patients may present with nonspecific gastrointestinal symptoms without signs of malabsorption, or with extraintestinal manifestations (without gastrointestinal symptoms)."

In daily practice, it is easier to identify celiacs through their non-digestive symptoms, because most of them do not present digestive symptoms, or are so mild that they do not give importance and go unnoticed, but their consultations focus on the rosary of multiple non-digestive symptoms. And we have to speak clearly to the people, so that they can identify what they suffer. In a disease that is autoimmune multiple-organ, it is very important to talk about extradigestive manifestations and, at least, to list some one.

The NICE guide can serve as an example: [5] I like the fact that it talks about digestive symptoms in general (we all know that they include diarrhea, constipation, bloating, nausea, etc.) and focus more on other types of manifestations. It could be considered something equivalent to what is intended with the infobox: a brief, schematic and informative list. We are trying to simplify a disease that is impossible to simplify.

About your proposal, Jrfw51 "Please consider if we should keep cancer, infertility and ataxia which are rare.", if we say that they are rare, we also have to specify which symptoms are rare, such as malabsorption. And thank you for suggesting other autoimmune diseases, I completely agree.

We also have to add in specialty "Internal Medicine". Internists also diagnose celiac disease (I am an internist as well as a gastroenterologist).

While we reach a consensus, it is better to leave the infobox as it was before and continue arguing here, until we reach a solution satisfactory for all of us.

Best regards. --BallenaBlanca (Talk) 18:19, 26 April 2017 (UTC)

I have linked "non specific" to the article on the topic.

Other autoimmune diseases are more associations than complications. Doc James (talk · contribs · email) 18:33, 26 April 2017 (UTC)

This improves it, but not completely. How about adding, at least, "extradigestive non-specific symptoms"? --BallenaBlanca (Talk) 19:16, 26 April 2017 (UTC)

Other autoimmune diseases are both associations and complications. It is correct to include them into complications. --BallenaBlanca (Talk) 19:20, 26 April 2017 (UTC)

The infobox is for a short list of key symptoms. Non specific symptoms may be GI and non-GI. The lead provides more details and we mention " a wide number of symptoms involving any part of the body" already which IMO is sufficient.

I have added other autoimmune diseases. Doc James (talk · contribs · email) 19:26, 26 April 2017 (UTC)

References

Tyranny of the minority?

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

---

Considering Wikipedia has far more American donors and users than Brits, does it not seem absolutely absurd that the minority can take over an entire article like this? An article that has nothing whatsoever to do with Britain? Americans ought to withhold all financial support from Wikipedia until this issue is corrected. — Preceding unsigned comment added by 71.212.236.3 (talk) 10:56, 3 May 2017 (UTC)

Leaving aside other considerations, which I think are not relevant, it makes no sense to say "An article that has nothing whatsoever to do with Britain". Celiac disease affects people in Britain, United States and any country in the world (where gluten is consumed) with a similar, and increasing, incidence. Best regards. --BallenaBlanca (Talk) 13:07, 3 May 2017 (UTC)

I do not know what this comment means? Doc James (talk · contribs · email) 19:41, 3 May 2017 (UTC)

Using British and European spelling and idioms is an irritating affection of those in the USA pretending to be sophisticated. They figure using conventional spellings, etc, makes the seem like rubes. — Preceding unsigned comment added by 73.170.88.70 (talk) 03:50, 18 June 2017 (UTC)

Or simply the standard for non-Americans… There is no such things as conventional spelling — and it would be even more confusing if we alternated between different spellings within the same article. This article was originally written with British spelling, hence it will continue to use British spelling as per our standards. This is not up for debate. If you want to debate whether Wikipedia should use British or American spelling go to WP:ENGVAR — I'm closing this discussion now. Carl Fredrik ^talk 10:51, 18 June 2017 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Small adjustment in the lede

I adjusted this sentence "...remain undiagnosed, usually because of non-classic, minimal, or absent complaints.", supported by a ref already present on the page by the World Gastroenterology Organisation, Global Guidelines: Celiac Disease, July 2016. A major obstacle is the lack of awareness of CD by pediatricians, primary-care physicians and also gastroenterologists. In general, there is a poor awareness of CD.

Page 12. There is an urgent need to increase awareness among primary-care physicians and pediatricians about the wide diversity of clinical manifestations and the role of serological testing in the diagnosis of celiac disease.

Page 8.● The most important obstacle to implementing the recommendations is poor awareness of celiac disease by patients and physicians. ● Among gastroenterologists, there is a sense that celiac disease does not require follow-up by a specialized physician after diagnosis and may be considered a minor condition in comparison with irritable bowel disease (IBD) and inflammatory bowel syndrome (IBS).

Best regards. --BallenaBlanca (Talk) 14:34, 30 June 2017 (UTC)

Have summarized to "In developed countries, it is estimated that five out of six cases remain undiagnosed, usually because of minimal gastrointestinal complaints and poor awareness of the condition." Doc James (talk · contribs · email) 17:19, 30 June 2017 (UTC)

IMO now is somewhat confused, a profane person will not understand.

Note that your edit has erased two of the most important facts of why CD is not recognized: non-classic symptoms and absent gastrointestinal complaints. Look at the comparison between your edit and the previous version of my edit: [6] At the very least, we have to maintain them.

In my edit, I replaced "non-classic" with "wide range of clinical manifestations" (I think is not too long). Look at the previous version:

"In developed countries, it is estimated that five out of six cases (83%) remain undiagnosed, usually because of non-classic, minimal, or absent complaints." and my edit "In developed countries, it is estimated that five out of six cases (83%) remain undiagnosed, usually because of minimal or absent gastrointestinal complaints, the wide range of clinical manifestations and poor awareness of celiac disease among physicians.

To summarize, we can do it in the prevalence, replacing "five out of six" by "83%" (both was previously in the page). I propose this:

"In developed countries, it is estimated that 83% of cases remain undiagnosed, usually because of minimal or absent gastrointestinal complaints, and poor awareness among health professionals of the wide variety of non-digestive symptoms."

Best regards. --18:23, 30 June 2017 (UTC)

How about "In developed countries, it is estimated that 80% of cases remain undiagnosed, usually because of minimal or absent gastrointestinal complaints and poor awareness of the condition."

The ref says the lack of awareness is not just among health professionals. We do not need both 80% and 4 out of 5. I do not care which one we go with. We already discuss. We already discuss non-classic and minimal symptoms in the first paragraph and do not need to repeat it in this sentence. Doc James (talk · contribs · email) 18:30, 30 June 2017 (UTC)

Well, I agree. If I am not mistaken, the reason for summarizing so much is because it is the lede, is it?

I will do the edit with your proposal.

Best regards. --BallenaBlanca (Talk) 11:25, 2 July 2017 (UTC)

Social and Cultural Section

This could be expanded on to include how Coeliac's disease affects society beyond the context of religion, especially western religions.Ksq4 (talk) 14:22, 2 February 2018 (UTC)

I wish to point out that oe is a diphthong in English language as it is a separate symbol œ. Modern keyboards lack the diphthong which is a problem for those who prefer to use the full symbol set instead of a subset. ae is another problem. — Preceding unsigned comment added by 24.244.32.182 (talk) 21:43, 18 February 2018 (UTC)

Video

Video explaining celiac disease

The video has now been removed. Looking back here a number of changes User:BallenaBlanca requested were carried out.

User:Jrfw51 also felt in that discussion that the content was reasonable. Doc James (talk · contribs · email) 23:05, 27 March 2018 (UTC)

@SarahSV: What is the problem with the video as it is now, after it was updated? To this unenlightened reader, the video appears to give a terrific overview of the complex series of events behind the disease. It would be very hard to present that information in prose in a way that educated anyone who was not already familiar with many of the details. Johnuniq (talk) 02:54, 28 March 2018 (UTC)

This is the problem: this is a good video for a few dozen years ago, for the traditional general knowledge of celiac disease, which basically everyone knows, but it does not reflect current advances. We can not continue thinking / talking about celiac disease as a simple digestive disease, it is a systemic autoimmune disease: The World Gastroenterology Organisation Global Guidelines (WGO) (2016) The most important obstacle to implementing the recommendations is poor awareness of celiac disease by patients and physicians. Among gastroenterologists, there is a sense that celiac disease does not require follow-up by a specialized physician after diagnosis and may be considered a minor condition in comparison with irritable bowel disease (IBD) and inflammatory bowel syndrome (IBS).(...) There is an urgent need to increase awareness among primary-care physicians and pediatricians about the wide diversity of clinical manifestations.

Two specialized entities of undeniable weight worldwide, among others, have updated the CD definition: the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the WGO.

• ESPGHAN: CD is an immune-mediated systemic disorder elicited by gluten and related prolamines in genetically susceptible individuals and characterised by the presence of a variable combination of gluten-dependent clinical manifestations

• WGO: Celiac disease (CD) is a chronic, multiple-organ autoimmune disease that affects the small intestine in genetically predisposed children and adults.

People who made the Osmosis video only know the classic ideas about CD: a digestive disease, with positive antibodies and villous atrophy. There were deficits practically at all points, they corrected some of them, but there are others that are very important and they have not corrected.

See for example in the list of symptoms, which starts at about 7:33: Children: abdominal distension, failure to thrive, diarrhea; Adults: chronic diarrhea, bloating, symptoms vary and a mention to the dermatitis herpetiformis. Well, with this approach we can recognize 10-15% of cases, nothing more.

Realize that the first reported evidence that celiac disease might present with extraintestinal manifestations was made by Shuster, Marks and Watson in 1963-65 and the first detailed descriptive study of patients with celiac disease and a neurological deficit was published by Cooke and Smith in 1966. Do not you think we've already lost too many years? Do not you think it's time to banish errors that are doing so much damage and are leaving almost most cases without recognizing?

The video of Osmosis dynamite all the work and the effort made during the last years, perpetuating all these errors of concept that is costing so many years to overcome.

Let's see a couple more examples of 2015, from Nature Reviews Gastroenterology & Hepatology (Impact Factor: 13.678):

• PMID 26260366 (2015). "Coeliac disease is a common disorder that can arise at any age and typically presents with a broad spectrum of symptoms. The disease is thought to be underdiagnosed, in part owing to the fact that coeliac disease is often characterized by associated conditions and extraintestinal manifestations that can misdirect and impede diagnosis. Some of these manifestations are direct consequences of autoimmunity, such as dermatitis herpetiformis or gluten ataxia, whereas others are indirectly related to inflammation and/or malabsorption including anaemia, osteoporosis, short stature and delayed puberty. Any organ from the central nervous system to joints, liver or teeth can be affected. In some cases, extraintestinal symptoms are the only clinical manifestations of coeliac disease or occur in conjunction with diarrhoea and malabsorptive symptoms. An increased awareness among medical practitioners of the variety of extraintestinal manifestations of coeliac disease is essential to improve diagnosis and treatment."

• PMID 26303674 "The abnormal immunological response elicited by gluten-derived proteins can lead to the production of several different autoantibodies, which affect different systems"

I made very detailed explanations in this discussion.

I have not changed my mind: the video must be updated or removed. I can not accept that the video is not improved because it requires a lot of time of work (we will have to dedicate the time that it takes, to have mediocre information and mediocre videos we already have hundreds of websites and videos on Youtube): "To give some perspective, making edits to these videos does not take 2 seconds. The edit we made on your suggestion took a couple of hours of work --OsmoseIt" or because "We feel your other suggestions are an expansion of the scope of the video, beyond what we want to cover for our target audience. --OsmoseIt". This is Wikipedia and we have to comply with Wikipedia policies and objectives, not Osmosis team objetives.

Anyway, notice my good will, because two years have passed, I'm having patience. This issue has now come to light for other wider reasons, alien to me; however, it is good to take this opportunity and that Osmosis resume CD video work. --BallenaBlanca 🐳 ♂ (Talk) 13:31, 28 March 2018 (UTC)

@Johnuniq: the videos have been produced by Knowledge Diffusion, Inc. as "freemium" content to encourage readers to subscribe to one of their Osmosis Prime plans (they are clear about that on YouTube), and they don't comply with WP:V and WP:MEDRS. I removed this particular video because BallenaBlanca, a specialist in gastroenterology, expressed concern about it in 2016, and although it was subsequently updated he continued to be concerned. [7] I was also worried about the reply from the Knowledge Diffusion rep, who said: "We feel your other suggestions are an expansion of the scope of the video, beyond what we want to cover for our target audience." [8] That's fair enough; they have every right to produce what they want for their target audience. But they don't have the right to do it on Wikipedia. SarahSV ^(talk) 15:15, 28 March 2018 (UTC)

re comment by @DocJames:. I do not now support the inclusion of this (or similar videos) in Wikipedia. As stated by @SlimVirgin:, this is an independent production by Osmosis, an outside company, and represents their synthesis of the subject for their audience. Their sources are not stated, failing to meet the standards of WP:V and WP:MEDRS, and cannot be edited by other users. These are my principal reasons, although I also share most of the concerns expressed by @BallenaBlanca:. Jrfw51 (talk) 16:24, 28 March 2018 (UTC)

NICE

Totally missed the publication of a NICE guideline (https://www.nice.org.uk/guidance/ng20) covering CD as a whole and not just screening/testing. Worth attempting to refresh some references... JFW | T@lk 10:34, 30 May 2018 (UTC)

Agreed Cas Liber (talk · contribs) 14:12, 30 May 2018 (UTC)

Sorry, JFW but I am not sure if I am fully understanding what you said. Excuse my language barriers. Could you clarify it to me, please?

Best regards. --BallenaBlanca 🐳 ♂ (Talk) 15:05, 30 May 2018 (UTC)

In the UK, NICE produces national guidelines that are generally (with some exceptions) considered very authoritative. They are generally based on a thorough systematic review of the evidence. I think we should therefore try to update some of the current older references in this article (more than five years old) in favour of this very recent guideline. JFW | T@lk 16:10, 30 May 2018 (UTC)

Oh, I understand, thank you very much for your kindness in explaining it to me! I agree that we can use it more, although it is a bit "schematic", but can also expand it by supplementing with more detailed current sources.

Best regards. --BallenaBlanca 🐳 ♂ (Talk) 16:49, 31 May 2018 (UTC)

Outcome measures

This might be something for the "Research directions" section: outcome measures for clinical trials have been agreed doi:10.1136/gutjnl-2017-314853 JFW | T@lk 11:27, 9 July 2018 (UTC)

Spelling discussion

Does not belong in the first sentence. I have moved to the body of the article. Doc James (talk · contribs · email) 02:25, 17 December 2018 (UTC)

We are not a dictionary. An indepth discussion of spelling does not belong in the first sentence. Doc James (talk · contribs · email) 04:16, 18 December 2018 (UTC)

I've left it as is for now other than fixing grammar in the body section you added, as it's not productive to simply change your edits and then have them reverted, etc. I think this all speaks as to a broader issue on Wikipedia though, wherein while the information is quite good, the copy editing is either poor or non-existent, and articles often are a mish-mash of style conventions. Most professional encyclopedias get around this by picking one convention and sticking to it. This wouldn't work for a collaborative endeavor such as Wikipedia English, but totally ignoring the issue also isn't working. Why else are there so many edits across myriad articles that have to be reverted because someone didn't understand that what they were fixing wasn't actually a typo? To help solve this, my original edit was to simply add a line that said, "spelled celiac disease in North America." Your issue with that though was that it was "not just North America." So, I adjusted it to be more specific, and then we ended up with a dictionary entry in the first line, which isn't the best way to structure an article. Now though we've ended up with an entire section in the body, which seems pretty silly to me; think, would we really want do that for every article with this issue? Instead, I propose adopting your phrasing in the first line, but adding an abbreviated style designation. It would read, "Coeliac disease, also spelled celiac disease (US), is a long-term . . ." That notation is standard practice in many places, and it would clear everything up in just two letters. We would also then be able to remove the body section. This could also be done in other article with the same issue.Jravid (talk) 07:56, 18 December 2018 (UTC)

I prefer the current version where the discussions about spelling have been relegated to a subsection. Variations in style are common throughout Wikipedia, and only thorough copyediting deals with that. JFW | T@lk 08:08, 18 December 2018 (UTC)

Agree with Doc James and Jfdwolff. I also prefer the current version. Best regards. --BallenaBlanca 🐳 ♂ (Talk) 23:01, 18 December 2018 (UTC)

Sounds good, will leave it as it is now. Jravid (talk) 05:46, 19 December 2018 (UTC)

In the spirit of this unintentionally longwinded discussion (my apologies for that), I've made the first line even more concise. I saw this convention in use on other pages (e.g. myxedema and Valsalva maneuver), and it seems less clunky. Feel free to undo if not to your liking. Thanks for indulging!Jravid (talk) 07:38, 19 December 2018 (UTC)

No strong opinion on that change. Doc James (talk · contribs · email) 12:49, 19 December 2018 (UTC)

Good conclusion. (I was wondering whether to introduce a further discussion on "spelled" vs "spelt"; but then, spelt is already relevant to gluten and cereals!) Jrfw51 (talk) 13:50, 19 December 2018 (UTC)

Additional words

We do not need "current" in diagnostic criteria

We do not need "very" in often difficult

The point is already clear. Doc James (talk · contribs · email) 05:50, 6 March 2019 (UTC)

Anxiety and depression

Surprised there's no mention of either in the article when there is so much content on correlation between celiac disease and anxiety and depression. Lapadite (talk) 23:59, 10 September 2019 (UTC)

@Lapadite77: Hi there. The only reason for that is that nobody has come across the kind of sources that would support such content. Have a look at WP:MEDRS so you know what kind of source we're looking for, and let us know if you're aware of any good sources. JFW | T@lk 21:05, 11 September 2019 (UTC)

Celiac disease

Hi one of my friends have celiac and recently studies came out saying that it causes retardation 24.187.167.116 (talk) 11:56, 7 December 2022 (UTC)

A Commons file used on this page or its Wikidata item has been nominated for deletion

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• Coeliac Disease.png

Participate in the deletion discussion at the nomination page. —Community Tech bot (talk) 00:07, 9 December 2022 (UTC)

Non-classic symptoms are *more* common than classic symptoms?

Obviously, *some* patients will present with symptoms that are not commonly seen in others.

But why call certain symptoms "classic symptoms" if the *majority* of patients don't have them?

I would be glad to be corrected by a medical professional, but as it stands currently, it looks like that particular line was written by an unknowledgeable person or someone with an agenda of including more people in the diagnosis. — Preceding unsigned comment added by EditorPerson53 (talk • contribs) 16:56, 2 October 2022 (UTC)

• It appears that the sources for that sentence are saying that the "classic" symptoms may be more common, especially because malnutrition and failure to thrive are becoming less common, but that, because the non-classic symptoms are more variable and present differently, it's hard to be sure. Also, "classic" has a bit of the meaning of "older", so I don't think the sentence is misleading. Perhaps it is a bit unclear, so please suggest better phrasing if you like. Abductive (reasoning) 03:22, 1 December 2022 (UTC)

WP:URFA/2020

A few sentences without sources and one unsourced image with a dubious copyright restriction (File:Coeliac Disease.png: "for exclusive use on Wikipedia"). A455bcd9 (talk) 14:51, 3 December 2022 (UTC)

• In addition to uncited text, there is some WP:CITATIONOVERKILL. This is sometimes the result of drive-by insertion of primary sources by editors promoting their own work, so a review of those instances where there are two to six citations should be conducted to see if they are all necessary, and to use the most recent, highest-quality source instead. SandyGeorgia (Talk) 23:48, 18 January 2023 (UTC)
• A check for dated text should be conducted throughout. For example:
  • Text in the lead cited to 2006 and 2017: As a result of screening, the diagnosis is increasingly being made in people who have no symptoms.[28] Evidence regarding the effects of screening, however, is not sufficient to determine its usefulness.[29] SandyGeorgia (Talk) 23:50, 18 January 2023 (UTC)

Coeliac related to Vascular Dementia

Seems like a good idea to have a comment on the possible relationship between coeliac and vascular dementia?

This is mentioned and referenced in wikipedia article; https://en.wikipedia.org/wiki/Vascular_dementia (refs 16 & 17)

Having a family member with coeliac, this is something I definitely want to be aware of and track.

Thanks! 71.204.156.118 (talk) 02:19, 14 February 2023 (UTC)

FA concerns still valid?

In December 2022, @A455bcd9: and @SandyGeorgia: noted concerns with the article (thread can be found in the archives here.) I still see uncited statements in this article. Are the concerns still being actively worked on, or is this a candidate to go to WP:FAR? Z1720 (talk) 03:18, 21 December 2023 (UTC)

Wiki Education assignment: Research Methods in Clinical Psychology

This article was the subject of a Wiki Education Foundation-supported course assignment, between 6 March 2024 and 9 May 2024. Further details are available on the course page. Student editor(s): Atopperkroog (article contribs).

— Assignment last updated by Atopperkroog (talk) 00:40, 19 April 2024 (UTC)

Neuropsychiatric comorbidities associated with Celiac Disease

I see the "Miscellaneous" section has a one-liner about "depression, anxiety, and other mental health disorders" being related to CD. That's the one and only time neurological and psychological comorbidities of CD is mentioned. I'm hoping to create a section that directly addresses this.

Although the relationship between CD and various conditions such as cerebellar ataxia, peripheral neuropathy, seizures, headaches, cognitive impairments, depression, anxiety, Autism Spectrum Disorder (ASD), bipolar disorder (BD), schizophrenia, eating disorders (ED), and attention deficit hyperactivity disorder (ADHD) are not fully understood, there is published literature suggesting a relationship exists with at least some of these conditions.

Some areas I'd discuss:

1. CD is a disposing factor for many neuropsychiatric disorders, perhaps due to the shared biological processes and networks associated with the GI system and the brain
2. Impacts of diagnosis and gluten-free diet on quality of life (QOL)
3. Importance of the gut microbiota in better understanding gluten digestion and its neurological manifestations
4. Elevated rates of social anxiety have been noted among CD patients

Please let me know if there's anything I can add to make this as comprehensive as possible. Happy to field any questions or concerns. Any other reputable sources I should reference?

Sources:

Alkhiari R. (2023). Psychiatric and Neurological Manifestations of Celiac Disease in Adults. Cureus, 15(3), e35712. https://doi.org/10.7759/cureus.35712

Giuffrè, M., Gazzin, S., Zoratti, C., Llido, J. P., Lanza, G., Tiribelli, C., & Moretti, R. (2022). Celiac Disease and Neurological Manifestations: From Gluten to Neuroinflammation. International Journal of Molecular Sciences, 23(24), 15564. https://doi.org/10.3390/ijms232415564

Hansen, S., Osler, M., Sanne Marie Thysen, Rumessen, J. J., Linneberg, A., & Line Lund Kårhus. (2023). Celiac disease and risk of neuropsychiatric disorders: A nationwide cohort study. Acta Psychiatrica Scandinavica, 148(1), 60–70. https://doi.org/10.1111/acps.13554

Lebwohl, B., Haggård, L., Emilsson, L., Söderling, J., Roelstraete, B., Butwicka, A., Green, P. H. R., & Ludvigsson, J. F. (2021). Psychiatric Disorders in Patients With a Diagnosis of Celiac Disease During Childhood From 1973 to 2016. Clinical Gastroenterology and Hepatology, 19(10), 2093-2101.e13. https://doi.org/10.1016/j.cgh.2020.08.018

Zingone, F., Swift, G. L., Card, T. R., Sanders, D. S., Ludvigsson, J. F., & Bai, J. C. (2014). Psychological morbidity of celiac disease: A review of the literature. United European Gastroenterology Journal, 3(2), 136–145. https://doi.org/10.1177/2050640614560786

Atopperkroog (talk) 15:16, 30 April 2024 (UTC)

Gluten-Dependent Activation of CD4+ T Cells by MHC Class II–Expressing Epithelium

I came across this study & thought it might interest other editors. As it is a primary study, as per WP:MEDRS#Avoid primary sources, do not use it as a citation in the article. Instead, please monitor reviews & surveys of the literature or systematic reviews for further studies for further coverage.

• Rahmani, S; et al. (2024). "Gluten-Dependent Activation of CD4+ T Cells by MHC Class II–Expressing Epithelium". Gastroenterology. doi:10.1053/j.gastro.2024.07.008.

Peaceray (talk) 17:15, 13 August 2024 (UTC)