Celiac Sprue (cont.)
Mohammed Wehbi, MD
Vincent W Yang, MD, PhD
Robin E Rutherford, MD
Simmy Bank, MD, MB, ChB
Mary L Windle, PharmD
BS Anand, MD
IN THIS ARTICLE
Celiac Sprue Signs and Symptoms
Gastrointestinal symptoms in children
Because celiac sprue affects the absorption of nutrients essential for growth, children who are affected may have impaired growth and consequently short stature. Other common signs and symptomsinclude the following:
The onset of the symptoms is usually gradual and coincides with the introduction of cereal into the diet. The symptoms usually diminish in adolescence.
Gastrointestinal symptoms in adults
Celiac sprue usually affects adults in the third to fourth decade of lifebut sometimes later. The signs and symptoms of celiac sprue are variable and may include the following:
Malabsorption of ingested fat results in the delivery of excessive dietary fat to the large bowel. The bacteria in the colon feast on the fats and other undigested and unabsorbed nutrients, generating intestinal gas resulting in bloating and flatulence. In addition, other substances are released, causing secretion of fluid into the intestine and hence diarrhea. Fatigue (tiredness) and weakness can result from the loss of electrolytes, such as potassium and magnesium, due to the diarrhea.
Nutrient and vitamin deficiencies
Iron and folic acid are essential for the production of normal red blood cells (erythrocytes). Abnormalities in the absorption of iron or folic acid may result inanemia (low red blood cell count). Vitamin B-12 deficiencies can also contribute to the anemia noticed in affected persons with a mechanism similar to that of iron and folic acid deficiencies.
Vitamin deficiencies may develop when malabsorption is present. Vitamins soluble in fat are commonly malabsorbed. These include vitamins K and D.
Nongastrointestinal (extraintestinal) features
Skin disorders can complicate the course of the celiac sprue. These conditions include dermatitis herpetiformis, an itchy skin condition characterized by a rash or blisters involving the extremities, the trunk, the buttocks, the scalp, and the neck.
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