The NICE also recommend offering serological testing for coeliac disease in people with metabolic bone disease (reduced bone mineral density or osteomalacia), unexplained neurological disorders (such as peripheral neuropathy and ataxia), fertility problems or recurrent miscarriage, persistently raised liver enzymes with unknown cause, dental enamel defects and with diagnose of Down syndrome or Turner syndrome.Some evidence has found that early detection may decrease the risk of developing health complications, such as osteoporosis, anaemia, and certain types of cancer, neurological disorders, cardiovascular diseases, and reproductive problems. They thus recommend screening in people with certain health problems.Serology has been proposed as a screening measure, because the presence of antibodies would detect some previously undiagnosed cases of coeliac disease and prevent its complications in those people. However, serologic tests have high sensitivity only in people with total villous atrophy and have a very low ability to detect cases with partial villous atrophy or minor intestinal lesions. Testing for coeliac disease may be offered to those with commonly associated conditions. Treatment
Diet
At present, the only effective treatment is a lifelong gluten-free diet. No medication exists that prevents damage or prevents the body from attacking the gut when gluten is present. Strict adherence to the diet helps the intestines heal, leading to resolution of all symptoms in most cases and, depending on how soon the diet is begun, can also eliminate the heightened risk of osteoporosis and intestinal cancer and in some cases sterility. The diet can be cumbersome; failure to comply with the diet may cause relapse.
Bifid uvula occurs in about 2% of the general population, although some populations may have a high incidence, such as Native Americans who have a 10% rate.Bifid uvula is a common symptom of the rare genetic syndrome Loeys–Dietz syndrome, which is associated with an increased risk of aortic aneurysm. Function
During swallowing, the soft palate and the uvula move together to close off the nasopharynx, and prevent food from entering the nasal cavity. It has also been proposed that the abundant amount of thin saliva produced by the uvula serves to keep the throat well lubricated.It has a function in speech as well. In many languages, a range of consonant sounds, known as uvular consonants, are articulated by creating a constriction of airflow between the uvula and the back of the tongue. The voiced uvular trill, written [ʀ] in the International Phonetic Alphabet, is one example; it is used in French, Arabic and Hebrew, among other languages. Due to the large amount of saliva produced from glands in the uvula that are absent in other mammals, it has been suggested that the uvula is an accessory speech organ.Stimulation of the uvula also causes the gag reflex to initiate. This is often a problem for people with uvula piercings, and a common method of inducing vomiting. Clinical significance
Inflammation
At times, the mucous membrane around the uvula may swell, causing the uvula to expand 3–5 times its normal size. This condition is known as uvulitis.