Case Study: Sarah's VIP Vacation - Understanding and Managing Celiac Disease Through Vasoactive Intestinal Peptide

Case Study: Sarah’s VIP Vacation – Understanding and Managing Celiac Disease Through Vasoactive Intestinal Peptide

Patient: Sarah M., 32-year-old female with a 5-year diagnosis of celiac disease.

Presenting Complaint: Acute onset of diarrhea, bloating, and abdominal pain following the consumption of a piña colada on a beach vacation.

Medical History: Diagnosed with celiac disease at 27 years old after experiencing chronic GI symptoms and unexplained weight loss. Maintains a strict gluten-free diet but admits to occasional accidental gluten exposure. No other notable medical history.

Diagnosis:

• Based on symptoms, travel history, and known celiac disease, the primary diagnosis is a gluten-induced inflammatory response in the small intestine.
• Further investigation, including stool testing and possibly endoscopy, might be necessary to rule out other potential causes or identify the specific gluten source.

Pathophysiology:

• Ingestion of gluten in Sarah’s piña colada triggered an autoimmune response in her small intestine.
• T-cells attacked the intestinal villi, damaging the lining and hindering VIP production.
• Without VIP’s guidance, intestinal permeability increased, leading to malabsorption, electrolyte imbalance, and the characteristic symptoms of celiac disease flare-up.

Management:

• Immediate: Supportive care with hydration and electrolyte management.
• Dietary: Strict gluten-free diet to avoid further immune activation and allow intestinal healing.
• Pharmacological: Consider short-term antidiarrheal and/or antispasmodic medication to manage symptoms.
• Probiotic Supplementation: May be recommended to replenish intestinal microbiota and potentially support VIP production.

**Education and **

• Educate Sarah on the importance of strict gluten-free adherence and potential sources of hidden gluten.
• Discuss strategies for safe travel and vacationing with celiac disease.
• Regular follow-up with the gastroenterologist to monitor progress and adjust management as needed.

Case Study Implications:

• This case highlights the importance of VIP in maintaining intestinal health and the potential consequences of gluten exposure in celiac disease patients.
• Early recognition and prompt management of gluten-induced flares can minimize symptoms and prevent long-term complications.
• Individualized education and support are crucial for empowering patients like Sarah to confidently manage their celiac disease and enjoy a fulfilling life.

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