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Tirma at his PCP office - investigating problem 2 - Celiac Disease (Has…
Tirma at his PCP office - investigating problem 2 - Celiac Disease
Has consumed gluten regularly in the last 6-8 weeks
Postive for Celiac Disease
PCP will refer to GI Specialist
Tirma needs to schedule an endoscopic biopsy of the small intestine to confirm damage and inflammation of the small intestinal villi due to celiac disease with the GI Specialist
Yes: Damage to Villi
Likely confirms this is the root cause of the nutritional deficiencies
Referred to Dietitian for Celiac Diet MNT - Gluten-Free Diet
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This can take approximately 1-8 weeks to schedule depending on insurance authorizations and the availability of the specialists new patient schedule
No: No Damage to Villi
The PCP can interpret the nutrition blood panel results to prescribe a MVI or specific vitamin or minerals Tirma is deficient of
Has not eaten a sufficient amount of gluten in the last 6-8 weeks
Trima must follow the “Gluten Challenge” consists of consuming two slices of wheat-based bread for 6-8 weeks
Have blood drawn at the lab for tTg-IgA test. The nutrition blood panel to screen for vitamin deficiency can be done at the same time to save time and money. Results should be available within a week
Negative for Celiac Disease
Negative for nutritional deficiencies from the blood panel.
Investigate problem 3 - Rheumatoid Arthritis
The PCP can order the antigen testing for RA or the PCP can refer Tirma to a rheumatologist
Positive for nutritional deficiencies from the blood panel
Investigate problem 1 - Microbiota Disturbance
PCP refers to GI specialist for EGD, colonoscopy, and/ or stool culture to identify damage to the gut lining and asses his gut microbiota profile
Postive for microbiota issues
GI specialist recommends pre/probiotics and refers to a dietitian for nutritional education and counseling
Negative for microbiota issues
This can take approximately 1-8 weeks to schedule depending on insurance authorizations and the availability of the specialists new patient schedule