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Magill’s Medical Guide, 9th Edition

Celiac sprue

by Ahmad Kamal

Category: Disease/Disorder

Also known as: Nontropical sprue, gluten-sensitive enteropathy

Anatomy or system affected: Intestines, joints

Specialties and related fields: Gastroenterology, internal medicine, nutrition, pediatrics

Definition: Inflammation of the small intestine resulting from an abnormal response to gluten in the diet.

CAUSES AND SYMPTOMS

The most common symptoms of celiac sprue are diarrhea and weight loss. Patients develop an inflammatory reaction to gluten, a protein found in wheat, rye, oats, and barley. This inflammation causes flattening of the fingerlike projections in the small intestine known as “villi,” thereby decreasing the surface area available for nutrient and fluid absorption. Thus, patients often have anemia (from malabsorption of iron and folic acid) and bone disease (from malabsorption of calcium and vitamin D). Other symptoms of celiac sprue can include muscle weakness, infertility, epilepsy, and psychiatric illnesses, although the mechanisms underlying these manifestations are less clear. Some patients develop a blistering, itchingrash on the skin known as “dermatitis herpetiformis.” Most patients come to medical attention at two years of age, after wheat is introduced into the diet. A small number of people develop the disease as adults. Research suggests that stress can trigger celiac sprue reactions, including extreme emotional stress, pregnancy, surgery, and infections.

Information on Celiac Sprue

Causes: Inflammation of small intestine from gluten in diet

Symptoms: Diarrhea, weight loss, anemia, bone disease

Duration: Chronic, with acute episodes lasting two weeks

Treatments: Elimination of gluten from diet, folic acid supplementation

TREATMENT AND THERAPY

The mainstay of therapy is elimination of gluten from the diet, which calms the inflammation and eventually allows the flattened villi to grow back. Symptoms usually improve within two weeks. Lack of improvement is most often the result of incomplete elimination of gluten. Alternative diagnoses-including infection, food allergies, inflammatory bowel disease, and lymphoma of the intestines-must also be considered.

The avoidance of gluten sounds straightforward, but it often requires significant dietary changes that must be rigorously followed throughout life. Most breads, pastas, and pastries must be avoided. Patients often benefit from counseling with a dietitian, since many processed foods contain gluten. Patients may also need to be screened for vitamin and mineral deficiencies. Folic acid supplementation is especially important for women of childbearing age. An x-ray to determine bone mineral density is sometimes helpful in patients with suspected vitamin D deficiency.

PERSPECTIVE AND PROSPECTS

Celiac sprue is a genetic disease. It is known to becaused by a mutation on chromosome 6, and attempts to identify the specific gene further are ongoing. Testing to determine whether one has celiac sprue includes blood tests for antibodies against gliadin, the offensive component of gluten. About 1 percent of the global population suffers from celiac sprue. People at higher risk for celiac sprue include those who have diabetes mellitus, an autoimmune disease, Down syndrome, or anemia and those with a family member who has celiac sprue.

See also Allergies; Anemia; Diarrhea and dysentery; Gastroenterology; Gastroenterology, pediatric; Gastrointestinal system; Gluten intolerance; Intestinal disorders; Intestines; Malabsorption; Malnutrition; Nutrition; Vitamins and minerals; Weight loss and gain.

For Further Information:

1 

A.D.A.M. Medical Encyclopedia. “Celiac Disease.” MedlinePlus, January 20, 2010.

2 

Green, Peter H. R., and Rory Jones. Celiac Disease: A Hidden Epidemic. Rev. ed. New York: William R. Morrow, 2010.

3 

Holmes, Geoffrey, C. Catassi, and Alessio Fasano. Celiac Disease. Abingdon, England: Health Press, 2009.

4 

Korn, Danna. Kids with Celiac Disease: A Family Guide to Raising Happy, Healthy, Gluten-Free Children. Bethesda, Md.: Woodbine House, 2001.

5 

Mahadov, Srihari, and Peter H. R. Green. “Celiac Disease: A Challenge for All Physicians.” Gastroenterology & Hepatology 7, no. 8 (August, 2011): 554-556.

6 

Parker, James N., and Philip M. Parker, eds. The Official Patient’s Sourcebook on Celiac Disease. San Diego, Calif.: Icon Health, 2002.

7 

Shepard, Jules E. Dowler. The First Year: Celiac Disease and Living Gluten-Free-An Essential Guide for the Newly Diagnosed. Cambridge, Mass.: Da Capo Lifelong, 2009.

8 

Tessmer, Kimberly A. Gluten-Free for a Healthy Life: Nutritional Advice and Recipes for Those Suffering from Celiac Disease and Other Gluten-Related Disorders. Franklin Lakes, N.J.: New Page Books, 2003.

9 

Wood, Debra, and Daus Mahnke." Celiac Disease." Health Library, January 28, 2013.

Citation Types

Type
Format
MLA 9th
Kamal, Ahmad. "Celiac Sprue." Magill’s Medical Guide, 9th Edition, edited by Anubhav Agarwal,, Salem Press, 2022. Salem Online, online.salempress.com/articleDetails.do?articleName=MMG2022_0241.
APA 7th
Kamal, A. (2022). Celiac sprue. In A. Agarwal, (Ed.), Magill’s Medical Guide, 9th Edition. Salem Press. online.salempress.com.
CMOS 17th
Kamal, Ahmad. "Celiac Sprue." Edited by Anubhav Agarwal,. Magill’s Medical Guide, 9th Edition. Hackensack: Salem Press, 2022. Accessed September 16, 2025. online.salempress.com.