Celiac Disease or Celiac Sprue
Celiac disease (Celiac sprue, gluten intolerance) is an immune disease that affects the small intestine in response to exposure to gluten. Gluten is a protein that is found in rye, barley, and wheat (a way to easily remember this is to think of the common ingredients found in beer – though there are "gluten free beers" available).
Gluten is frequently used as a food additive to thicken, stabilize, and flavor foods, as well as used in other non-food products such as lip balm and vitamin supplements. When gluten is ingested, an immune response is triggered that causes inflammation in the small intestine (the small intestine is located between the stomach and colon). This inflammatory response affects the small intestine's ability to absorb nutrients. This in turn causes malabsorption, iron deficiency, and may lead to other problems. Celiac disease tends to be hereditary and mainly affects those of Western European descent, though there is marked geographic variation. Patients may have a variable presentation from having no symptoms at all to a severe illness. Gastrointestinal symptoms are common including diarrhea, fatty stools, excessive gas, and weight loss. Non-gastrointestinal signs and symptoms include anemia (low red blood cell count concentration of the blood), bone mineral loss, neurologic complaints, skin rash, liver and fertility problems. Diagnosis can be made with a combination of blood tests and biopsy of the small intestine during an upper endoscopy or esophagogastroduodenoscopy (EGD). Treatment requires a commitment by the patient to avoid gluten (gluten free diet). A trial of avoiding gluten and reassessing a patient thereafter may also aid in making a diagnosis. There are a number of internet support groups and associations that may help a person learn more about Celiac disease (Celiac Sprue Association® www.csaceliacs.info, "The Celiac Disease Awareness Campaign" www.celiac.nih.gov, and Gluten Intolerance Group www.gluten.net).
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