Celiac Sprue – Gluten Allergy

What is Celiac Sprue?
Celiac Sprue is basically an allergy to a dietary protein called gluten. Gluten is found in several grains: wheat (all forms including durum, semolina, kamut and faro), rye, barley, and triticale. Celiac Sprue (Celiac Disease) is a lifelong digestive disorder that affects genetically susceptible individuals. When people with Celiac Disease eat gluten it can cause damage to the lining of the small intestine which can then interfere with the absorption of nutrients.

Symptoms of Celiac Disease
Celiac Disease may appear at any time in the life of a person with a hereditary pre-disposition. Many people may not have any symptoms for years; the disease may become “active” for the first time after an event such as surgery, a viral infection, severe emotional stress or pregnancy. Symptoms of Celiac Disease are extremely varied and can often mimic other gastrointestinal complaints. Infants and children often exhibit growth failure, bloating, vomiting and behavioral changes. The classic symptoms in adults are: abdominal cramping, intestinal gas, distention and bloating, diarrhea and/or constipation, and weight loss or weight gain. Other symptoms may include fatigue, osteoporosis, defects in dental enamel, iron deficiency anemia, infertility and recurrent sores in the mouth.

Diagnosis of Celiac Disease
Because the symptoms of Celiac disease are so non-specific it often takes patients several years to get a positive diagnosis.

There are several blood tests that are available to assist your doctor in screening for Celiac Disease. These will test for antibodies to the disease in your bloodstream. For these blood tests to be accurate you must be consuming gluten at the time of testing.

The blood tests for Celiac Disease are not always 100% accurate so the “gold standard” for diagnosis of Celiac Disease is a small bowel biopsy. This is a painless procedure done at the time of an Upper Endoscopy. This will also allow your doctor to assess the extent of mucosal damage in your small intestine.

Treatment of Celiac Disease
There are no medicines to cure Celiac Disease. The only way to stop the symptoms and the damage is to adhere to a gluten-free diet for the rest of your life. Once gluten is removed from the diet, the small intestine will begin to heal and your overall general health will improve. Your doctor may recommend that you have a bone density test to asses for osteoporosis (bone loss). You may be placed on certain nutritional supplements to correct any deficiencies.

It can be very difficult to adapt to a gluten-free diet, but thankfully there are many new resources available to patients with Celiac Disease. There are several websites available, cookbooks and even gluten-free bakeries; health-food stores are a great resource. There are also support groups in most areas; many people find it very helpful to taIk to other people dealing with this disease and share food tips and recipes. It is important to read labels very carefully, as there may be many hidden sources of gluten in foods. In addition to the standard grains of wheat, barley, rye and triticale, some unlikely foods that may contain gluten are:

  • Brown rice syrup
  • Caramel color
  • Malt or malt flavorings
  • Beer
  • Modified food starch from unknown source
  • Cold cuts
  • Soups
  • Candies (licorice, jelly beans)
  • Soy sauce
  • Many low or nonfat packaged foods
  • Some alcohols and vinegars
  • Some medications contain gluten as a binder