Celiac sprue

Article Abstract:

Childhood celiac disease was recognized over 100 years ago. It was only after the second world war that a physician recognized the association between the symptoms of celiac disease and eating products containing wheat or wheat flour. Very rapidly, it was determined that the disorder resulted from a reaction to gliadin, which is one component of gluten, the water-insoluble protein in wheat flour. Intestinal lesions that develop in response to gliadin impair the absorption of fats and result in the symptoms of celiac disease. As more was learned it became clear that the adult disease called nontropical sprue was the same as childhood celiac disease. The majority of patients with celiac disease respond to gluten-free diets, but many questions remain about the condition. The author provides a detailed discussion of the pathogenesis, clinical features, and treatment of celiac disease. Celiac disease is essentially non-existent in Orientals and Africans. In white populations, the prevalence ranges from 1 in 1,000 to 1 in 2,000, although it is certain that there are many undiagnosed cases. The number of new cases diagnosed each year tends to fluctuate, which suggests that some environmental factor may help to precipitate the disease. There is not yet a definitive explanation for the cause of celiac disease. Some researchers favor a genetic predisposition, while others suspect immunological mechanisms. These two possibilities are, of course, not mutually exclusive. Patients with celiac disease are also more likely to develop malignant diseases, especially lymphoma. The minority of celiac disease patients who do not respond to a gluten-free diet may respond to treatment with steroid drugs. However, many of these patients will not respond to steroid treatment and may face a dismal prognosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Malabsorption syndromes

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A 76-year-old woman with recurrent diarrhea several months after treatment for tropical sprue

Article Abstract:

A 76-year-old woman was diagnosed with Crohn's disease complicated by infectious gastroenteritis. The patient was admitted to the hospital with chronic diarrhea. She was treated successfully with antibiotics for suspected tropical sprue, or tropical diarrhea, which she developed eight months earlier during a trip to India. After approximately four months, the diarrhea recurred. Her condition did not improve, despite treatment with pancreatic enzymes and a lactose-free diet. A computed tomographic (CT) scan of the abdomen and pelvis showed several dilated loops in the middle portion of the small intestine. Other loops in the small intestine showed moderate thickening of the intestinal wall. A radiological study of the upper gastrointestinal tract revealed segmental dilation in the small intestine with narrowing in some areas. The patient was diagnosed with Crohn's disease after an exploratory laparotomy.

Case studies, Crohn's disease, Gastroenteritis

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A comparison of diets with and without oats in adults with celiac disease

Article Abstract:

The consumption of oats may not aggravate celiac disease in adults who avoid dietary gluten. Celiac disease involves the breakdown of the intestinal lining and may be treated with a diet free of rye, wheat, and other gluten sources. Forty people with recently diagnosed celiac disease and 52 people with the disease in remission followed a gluten free-diet. Each of these groups was divided into sub-groups which either avoided or consumed oats. Average oat consumption was 47 grams per day among new patients at 1 year and 50 grams a day among patients in remission at 6 months. According to examination and biopsies of the digestive tract, people in remission remained in remission whether or not they consumed oats. Within one year, all but one of the newly diagnosed patients went into remission regardless of oat consumption. Side effects in both control and oat groups included itching and abdominal symptoms.

Health aspects, Oats, Gluten-free diet

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