Overview of Disease

Celiac Sprue, also known as Celiac Disease, Gluten-Sensitive Enteropathy, or Non-Tropical Sprue, is a life-long intestinal disease that is caused by the ingestion of gluten, a protein component of wheat, rye, and barley.  In genetically-susceptible people, gluten triggers a series of immune-mediated events that leads to inflammation and damage to the lining of the small intestine, preventing absorption of critical nutrients. 

Treatment
The primary current treatment for Celiac Sprue is the life-long adherence to a gluten-free diet, requiring the complete elimination of all food products containing wheat, barley, and rye. 

History of Disease
Celiac Sprue was once thought to be a rare pediatric disease.  We now know from blood donor studies that it is a common disease affecting as many as 1 in 133 people in the U.S from a variety of ethnic groups.  Unfortunately, the vast majority of people in the U.S. with this disease are undiagnosed. 

Diagnosis
Individuals can be screened for Celiac Sprue by blood tests looking for certain antibodies, but the actual diagnosis is made when characteristic changes are seen in the biopsy of the small intestine.  First and second degree relatives of Celiac patients are at increased risk of the disease and should be screened.

Symptoms
Celiac Sprue can cause a wide range of symptoms both related and unrelated to the gastrointestinal tract including:

• diarrhea
• weight loss
• abdominal bloating
• abdominal pain/discomfort
• nausea/vomiting
• constipation
• rapid filling after small meals
• excessive gas passage
• fatigue/weakness
• muscle or joint pains
• depression
• anxiety 

Conditions/Diseases Associated With Celiac Sprue
There are also numerous conditions/diseases that are associated with Celiac Sprue such as

• autoimmune thyroid disease
• type 1 diabetes
• dermatitis herpetiformis
• selective IgA deficiency
• autoimmune hepatitis

Poorly controlled Celiac Sprue can result in:

• anemia
• decreased bone density
• lactose intolerance
• short stature
• delayed puberty
• infertility
• recurrent miscarriages
• nerve dysfunction
• dental enamel defects
• intestinal cancer

Importance of Follow-up Care
Many Celiac patients do not receive any follow-up care, either because they are unable to find a physician who is knowledgeable about the disease or because they feel that they are doing well on their own. Studies have shown, however, that a substantial proportion of Celiacs are not in remission, even patients who are asymptomatic. Therefore, we strongly advocate that Celiacs receive regular follow-up care to monitor their disease activity and prevent complications. This is also recommended by the National Institute of Health Celiac Sprue Consensus Conference panel which met in June 2004.