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K90.0 – Coeliac Disease: Causes, Symptoms & Treatment
K90.0 is the ICD-10 code for coeliac disease, a chronic autoimmune disorder of the small intestine triggered by gluten, leading to intestinal damage and malabsorption.
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K90.0 is the ICD-10 code for coeliac disease, a chronic autoimmune disorder of the small intestine triggered by gluten, leading to intestinal damage and malabsorption.
What is K90.0 (Coeliac Disease)?
K90.0 is the ICD-10 diagnosis code for coeliac disease (also spelled celiac disease), a chronic, immune-mediated disorder of the small intestine. It is triggered by the ingestion of gluten, a protein complex found in wheat, barley, rye, and related grains. Coeliac disease affects approximately 1% of the global population and can develop at any age.
Causes and Risk Factors
Coeliac disease is an autoimmune condition: the immune system reacts to gluten as though it were a pathogen, mistakenly attacking the lining of the small intestine. This leads to destruction of the intestinal villi, the tiny finger-like projections responsible for nutrient absorption.
- Genetic predisposition: Carriers of HLA genes DQ2 or DQ8 have a significantly increased risk.
- Family history: First-degree relatives of people with coeliac disease are more frequently affected.
- Other autoimmune conditions: People with type 1 diabetes or Hashimoto thyroiditis have a higher risk.
- Environmental factors: Childhood infections and the timing of gluten introduction in infancy may play a role.
Symptoms
The symptoms of coeliac disease are highly variable and can affect both the digestive tract and other organ systems.
Gastrointestinal Symptoms
- Chronic diarrhoea or soft, fatty stools (steatorrhoea)
- Abdominal pain and bloating
- Nausea and vomiting
- Unintentional weight loss
Extra-Intestinal Symptoms
- Fatigue and exhaustion due to malabsorption
- Iron-deficiency anaemia
- Osteoporosis due to calcium deficiency
- Neurological symptoms such as tingling or balance disturbances
- Skin changes: dermatitis herpetiformis (an itchy, blistering rash)
- Growth delays in children
Importantly, many individuals with coeliac disease have no or minimal gastrointestinal complaints, which can make diagnosis challenging.
Diagnosis
The diagnosis of coeliac disease (ICD-10: K90.0) involves several steps:
- Blood tests: Detection of antibodies against tissue transglutaminase (tTG-IgA) and endomysial antibodies (EMA). Total serum IgA levels are also measured.
- Duodenal biopsy: Tissue sampling from the small intestine via gastroscopy, showing villous atrophy and increased intraepithelial lymphocytes (Marsh classification).
- HLA typing: Used as an exclusion test; absence of HLA-DQ2/DQ8 virtually rules out coeliac disease.
- Response to a gluten-free diet: Improvement in symptoms and mucosal findings on a gluten-free diet supports the diagnosis.
Treatment
The only established treatment for coeliac disease is a strict, lifelong gluten-free diet. Gluten must be completely eliminated from the diet, including hidden sources in processed foods, medications, and cosmetics.
- Permitted foods: Rice, maize, potatoes, millet, buckwheat, quinoa, meat, fish, dairy products, legumes, vegetables, and fruit (without added gluten).
- Foods to avoid: Wheat, spelt, rye, barley, emmer, einkorn, and any products derived from them.
- Nutritional supplementation: Due to deficiencies, supplementation with iron, folate, calcium, vitamin D, and vitamin B12 is often required.
- Regular medical follow-up: To monitor mucosal healing and nutritional status.
With strict adherence to a gluten-free diet, intestinal villi typically recover fully and symptoms resolve. Untreated coeliac disease increases the risk of complications such as intestinal lymphoma and osteoporosis.
References
- Ludvigsson, J.F. et al. (2013): The Oslo definitions for coeliac disease and related terms. Gut, 62(1), 43–52. DOI: 10.1136/gutjnl-2011-301346
- Rubio-Tapia, A. et al. (2013): ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease. American Journal of Gastroenterology, 108(5), 656–676.
- World Gastroenterology Organisation (WGO) Global Guidelines: Celiac Disease (2016). www.worldgastroenterology.org
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