A 55 year old man with coeliac disease presents with ongoing diarrhoea and weight loss despite a strict gluten free diet. What is the most appropriate...

Question

A 55 year old man with coeliac disease presents with ongoing diarrhoea and weight loss despite a strict gluten free diet. What is the most appropriate next step in investigation?

Accepted Answer

Check for IgA deficiency and consider repeat biopsy to exclude refractory coeliac disease or other pathology

Answer

Reassure that symptoms are functional

Answer

Start long term steroids empirically

Answer

Advise stopping the gluten free diet

Answer

Only prescribe loperamide without further tests

uk-plab-1 MCQ (SBA): Refractory symptoms in coeliac disease

A 55 year old man with coeliac disease presents with ongoing diarrhoea and weight loss despite a strict gluten free diet. What is the most appropriate next step in investigation?