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Diseases
Celiac Sprue
Celiac Sprue (CS) is a disorder resulting from an immune reaction to gluten, a protein found in wheat (wheat products, barley, rye and to a lesser extent, oats). It causes impaired absorption and digestion of nutrients in the small intestine. This genetic disorder tends to be most common in people of northern European descent. It can occur in all ages, from infants to older adults. It’s also sometimes called Celiac Disease, gluten enteropathy or gluten intolerance.
Click on the statements/questions below to reveal the answers to the causes, symtoms and
signs of this particular disease.
Symptoms and diagnosis
In children, there may be irritability, diarrhea, nausea, vomiting and failure to thrive or grow. The same symptoms may occur in adults along with abdominal pain, weight loss, anemia or low red blood cell count, mood changes, joint and muscle pain, fatigue, skin rashes and menstrual irregularity.
Your physician may suspect CS based on symptoms, medical history and abnormal blood tests such as a low red blood cell count. If those indicate the possibility of Celiac sprue, your doctor will conduct an endomysial antibody test. A biopsy of the lining of the small intestine is needed to confirm the diagnosis – this is done with a test called an upper endoscopy, also called an EGD (esophagogastroduodenoscopy).
The gluten-free diet
Celiac sprue is treated through dietary modification by avoiding the gluten protein. Wheat, rye, barley and perhaps oats are the culprits. They are present in many canned and prepared foods. The patient (or parent) must become a label-reader to determine if wheat in any form exists. Instead of wheat flour, the patient may use potato, rice, soy or bean flour. Specialty stores (and many mainstream grocery stores) sell gluten-free breads, pasta and other gluten-free products. Meat, fish, poultry, fruits and vegetables are naturally gluten-free and are good dietary choices.
Patients with CS (and their food preparer) should see a registered dietician for several sessions to learn more about this complicated diet. Eating out can be a challenge, since sauces are often made with wheat-based products.
Although this may seem daunting, once known and understood, the diet can be fairly easy to follow. Most patients see improvement in their condition after dietary changes are undertaken – this improvement often increases motivation to maintain proper diet.
Other disorders
Because CS is a disorder of the immune system and the genes, it is often associated with other diseases that have similar causes. These include:
- dermatitis herpetiformis
- lupus
- diabetes occurring in childhood or requiring insulin
- rheumatoid arthritis and other immune related disorders
Complications of CS
There are certain complications known to develop with celiac sprue, but they can usually be prevented by conforming to a strict gluten-free diet. These include:
- malignancies of the intestines
- osteoporosis
- failure to grow in height or weight
- deficiencies of minerals (iron) and vitamins which, in turn, can lead to convulsions when inadequate folic acid is absorbed
Words to Know
Dermatitis Herpetiformis:
An autoimmune blistering disorder associated with a gluten-sensitive enteropathy. This extremely itchy chronic rash is characterized by bumps and blisters.
Endomysial Antibody Test:
A blood test to identify the presence of circulating IgA endomysial antibodies (EMA), which are present in 70-80% of patients with dermatitis herpetiformis and in nearly all patients with celiac disease who are not adhering to a gluten-free diet.
Lupus:
A chronic inflammatory condition caused by an autoimmune disease. An autoimmune disease occurs when the body's tissues are attacked by its own immune system.
Rheumatoid Arthritis:
An autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints and other organs in the body. Autoimmune diseases occur when the body tissues are mistakenly attacked by its own immune system. Some people confuse rheumatoid arthritis with osteoarthritis which is degeneration of specific joints.
Small Intestine: The part of the digestive tract that extends from the stomach to the large intestine. It is 20 feet long and is responsible for absorbing nutrients, calories, vitamins and minerals into the blood.