An 89-year-old woman with a past history of celiac disease, GI bleed, and dementia presented to the ICU with a complaint of recurrent GI bleeding. She was in her usual health 2 days back when she developed nausea with multiple bouts of coffee ground emesis. Past history: She has been diagnosed having the celiac disease 2 years back by a duodenal endoscopic biopsy with a correlative serum tissue transglutaminase IgA antibody. She was advised a gluten-free diet which she did not comply with because of her early dementia.
She was treated with additional oral budesonide for chronic abdominal discomfort. She reported a significant weight loss and poor appetite since one year which was diagnosed as celiac disease-related malabsorption. Her past medical history also included a prior admission with similar symptomatology with anemia. Gastroscopy, at that time, showed gastritis and duodenitis…
