Atlanta Center for Gastroenterology, PC
& Atlanta Endoscopy Center, LTD
Offices of David Rausher, M.D., F.A.C.G., A.G.A.F., and Charles Parrish, M.D.
Understanding Celiac Disease
Celiac Disease: what is it?
Celiac Sprue: what does this term mean?
What is Celiac Disease?
An immune reaction to gluten, a protein found in wheat, barley and rye.
What is Celiac Sprue?
Celiac Sprue is a medical term that describes a condition found in individuals with an allergy to gluten, a dietary protein found in wheat, barley and rye. The allergic reaction causes inflammation in the lining of the small intestine, which is the part of the body between the stomach and large intestines where nutrients are absorbed. As a result, many people with celiac sprue may develop signs of malabsorption because the bowel becomes inflamed and will not properly absorb nutrition. In this case certain complications may arise including iron deficiency anemia, osteoporosis, bone fractures, defects in dental enamel, infertility, miscarriages or menstrual irregularity, impaired blood clotting & recurrent mouth sores. Many with celiac sprue may also have diarrhea and weight loss.
Any other medical terms this disorder is often referred to as?
The disorder is also known as nontropical sprue, idiopathic sprue, celiac disease, gluten-sensitive enteropathy and gluten-induced enteropathy.
What causes the allergy to gluten?
The cause is unknown.
Who is at risk for developing Celiac Sprue?
Celiac Sprue most often affects people of western European ancestry. It is slightly more common in people with an Irish background and very rare in people from Africa, China, Japan or the Caribbean. An individual can develop the allergy at any age.
How is it diagnosed?
There are several blood tests that screen for very specific elements that indicate Celiac Sprue. A diagnosis is usually confirmed with a biopsy of the lining of the small intestine. The biopsy is taken during a procedure called an upper endoscopy. Because of the nature of the symptoms of Celiac Sprue, it can be difficult to diagnose. Your physician may also test liver and kidney function as well as other general blood tests to rule out other conditions with similar symptoms.
What is the treatment for sprue?
There is no “treatment,” other than avoiding foods that contain gluten. This means a substantial change in diet, because in addition to wheat, barley and rye, many processed and convenience foods are made with additives and preservatives that contain gluten or related products. Beer, lagers, ales and stouts must be avoided, although wine, liqueurs, most ciders and spirits, including whiskey and brandy, are permitted. Switching to products that contain only rice, corn, maize, buckwheat, potato, soybean or tapioca flours is highly recommended. Your physician and a nutritionist can make additional suggestions and help guide you in making this dietary change.
Is there a cure?
There is no cure for Celiac Sprue. The only way to prevent the allergic reaction is to stay on a gluten-free diet. The good news, though, is that the small intestine can heal itself and resume normal absorption of nutrients within several months of changing and closely monitoring what you eat.
What happens if I don't stay on the diet?
Your symptoms will come back.
Are there other conditions associated with Celiac Sprue?
Yes. Some adults may have a painful, itchy, gluten-sensitive skin rash called dermatitis herpetiformis that causes raised red blotches on the elbows, knees and buttocks. Insulin dependent diabetes, liver enzyme abnormalities and thyroid disorders may also be associated with sprue. If the inflammation in the small intestine is not controlled, people with the allergy also have a greater risk of Non-Hodgkin’s lymphoma, osteoporosis and intestinal malignancies. These risks can be reduced by avoiding all products containing gluten.
After the allergic reaction is under control, do I need to keep seeing my doctor?
Yes. Because sprue is a life-long condition, it’s important to maintain regular check-ups to monitor nutrition and overall health.