Question

 1. A dietitian is counselling a patient with celiac disease

who has experienced steatorrhea for a number of years.

The dietitian, in addition to describing appropriate

carbohydrates,lipids and protein that will not trigger the

malabsorption issue,also encourages the patient to take

certain vitamins. Which of the following vitamins is most

likely on this list?

 A. Vitamin C

 B. Folic acid

 C .Vitamin K

 D. Vitamin B12

 E. Thiamine​

Answer 1

Celiac disease (CD) is a primarily digestive systemic disease triggered and maintained by the ingestion of gluten in the diet. Its has a wide clinical spectrum of manifestations, particularly varied in adult patients, in whom, because of their frequent negative serology and mild, nonspecific symptoms, there is a considerable delay in diagnosis. The intestinal lesion caused by CD leads to various deficiencies of nutrients, vitamins, and dietary minerals, with ferropenia, vitamin B12, folic acid, and fat-soluble vitamin deficiencies being especially frequent. The deficiencies, together with dairy intolerance, cause low bone density and an increased risk of fractures. Treatment using a gluten-free diet (GFD) does involve certain complications, since gluten is found in up to 70% of manufactured food products and manufacturing regulations are not standard in all countries. In addition, certain nutrient deficiencies require specific management. This article reviews the nutritional aspects of CD and provides practical guidelines to correct these deficiencies and to ensure optimum GFD compliance.