Celiac Sprue is a disease of the small bowel, caused by a reaction to gluten, a protein found in wheat, barley and rye. About one out of every thousand people in the general population has the disease. This familial disease is most common in Western Ireland. Affected individuals poorly absorb fat, iron, vitamin D, calcium and other nutrients, resulting in symptoms of abdominal bloating, malaise, easy fatigability, abdominal cramps, diarrhea, thin bones and skin rashes.

The diagnosis is confirmed by a response to a gluten-free diet and either a special blood test (antiendomysial or antigliadin antibodies), or a small bowel biopsy obtained during endoscopy. A small bowel follow through may provide information about extent of disease in advanced cases.

Treatment is based on a life-long gluten free diet and specific additional treatments and supplements as indicated on a individual basis. Life-long follow up is needed to monitor the individual for potential complications such as strictures, ulcers, cancers and lymphoma.

This disease has a variable expression so that some patients will have only very mild symptoms like one or two loose stools per day, whereas others will present initially with symptoms of an unexpected bone fracture or severe anemia. It is typical for the disease to remain undiagnosed for years until the individual undergoes specialized testing by a Gastroenterologist.

The National Celiac Sprue Association has evolved into an excellent patient support and resource available to all.

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