Celiac sprue is a disease of the small intestine that is associated with an allergy to gluten. Gluten is found in a wide variety of substances. Oats, barley, wheat as well as foodstuffs such as ketchup and mustard may contain significant amounts of gluten. Severe malabsorption of food with subsequent loss of protein, and fat-soluble vitamins may occur.
Most patients have diarrhea, bloating, gas and malnutrition as primary problems associated with celiac sprue. However, patients may have some (or none) of these associated diseases. If you have chronic diarrhea, celiac disease may be present.
The diagnosis of celiac sprue can be done through blood tests (endomysial antibody and anti-gliadin antibody tests). Usually, the blood tests are supportive evidence. Visualization of the small bowel during an EGD during a small bowel series ( radiographic evaluation) is extremely helpful. The most specific diagnostic test is a small bowel biopsy. This can be done at the time of an endoscopy ( EGD). The exact sequence of testing may be any or all of these tests. Each case is individual.
The treatment is avoidance of gluten containing foodstuffs, correction of nutritional deficits and follow-up of associated diseases.
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