Celiac Sprue

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Celiac sprue, also known as celiac disease, gluten-sensitive enteropathy, and gluten-induced enteropathy, is a chronic disease of the digestive tract that interferes with the digestion and absorption of nutrients from food. People with celiac sprue cannot tolerate gluten, a protein commonly found in wheat, rye, barley, and to some degree, oats. When affected individuals ingest foods containing gluten, the lining (mucosa) of the intestine becomes damaged due to the body's immune reaction. Because the lining of the intestine contains essential enzymes for digestion and absorption, its destruction leads to malabsorption, a difficulty in absorption of food and essential nutrients. As result, celiac sprue is often considered a malabsorption disorder.

Persons with celiac sprue experience improvement in the condition when on a strict, gluten-free diet and relapse when dietary gluten is reintroduced. With treatment,celiac sprueis rarely fatal. However, untreated and unrecognized celiac disease may slightly increase the risk of developing intestinal lymphoma, a form of cancer.

Celiac sprue is a genetic disease; the genes for this condition may be transmitted to some family members and not to others. Sometimes the disease is triggered, or becomes apparent for the first time, after surgery, pregnancy, childbirth, viral infection, or severe emotional stress. Celiac sprue is rare in persons with an African American, Caribbean, or Asian background. Females are slightly more affected than males. Although celiac sprue can manifest at any age,the detection of this disease usually peaks at8-12 months andin the third to fourth decade of life.

The true prevalence of celiac sprue is not known. The increased awareness and the availability of better diagnostic tests have led to the realization that the disease is relatively common. The highest prevalence is in Western Europe and in places where Europeans emigrated, notably North America and Australia. In these regions, celiac sprue affects approximately 1 of every 250-300 individuals. In the United States, the estimated prevalence is 1 case per 3,000 in the population. However, this rate is likely an underestimation; a recent study involving 2,000 healthy blood donors showed an estimated prevalence of 1 case in 300.

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