Celiac Sprue

Also Know As Celiac Disease, Gluten Sensitive Enteropathy (GSE)

Coeliac (Celiac) disease

Celiac sprue is a long term disease condition that involves food digestion and absorption. Gluten is a term used to refer to a protein available in some foods like wheat and rye. Individuals with celiac sprue cannot tolerate this type of protein thus malabsorption ensues. ^[1]

Epidemiology

1 in 3000 people is affected in the U.S. The highest prevalence is recorded at European countries such as Ireland and Finland. Diagnosed individuals are either very young (less than 1 year old) or in the third to fourth decade of life. Females are more commonly affected. ^[2]

Causes

Celiac sprue is genetically associated. ^[2] A person can be affected at any age. Celiac sprue most frequently occurs among Europeans and Caucasians usually females. Those with the disease are more prone to develop other medical conditions such as Down syndrome, diabetes type 1, malignancies in the digestive tract, autoimmune diseases and malabsorption syndromes like lactose intolerance. ^[3]

Signs and Symptoms

Symptoms vary. A person can have diarrhea or constipation. Nonspecific symptoms include abdominal pain, appetite loss, nausea and vomiting. Because the condition is a malabsorption type, a person can experience symptoms referable to lack of vitamins and minerals such as stunting, ulcers in the mouth area, hair loss, easy bruising, loss of sensation, weakness and skin itchiness. An individual can also develop hormonal and skin disorders. ^{[2] [3]}

Diagnosis

Blood tests are performed. The most sensitive exam is a test for antibodies. Upper endoscopy is often done in order to visualize the digestive tract and to obtain sample after. Laboratory exams that may be carried out include obtaining the albumin, alkaline phosphatase, liver enzymes and serum cholesterol. Stool exams, oral tolerance tests and genetic exams also help. Sometimes imaging studies are requested such as a barium test. ^{[2] [3]}

Treatment

The chief means to address celiac sprue is by controlling the diet which necessitates the removal of gluten. Corticosteroids can be given in particular to those who do not have symptom improvement with gluten elimination. Vitamin and mineral supplements are also given in order to address nutritional deficits. ^[2]

References:

1.      http://www.emedicinehealth.com/celiac_sprue/article_em.htm

2.      http://emedicine.medscape.com/article/171805-overview

3.      http://www.nlm.nih.gov/medlineplus/ency/article/000233.htm

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