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The name sprue derives from a Dutch word describing inflammation of the mouth, which is a frequent symptom. The disease has been recognized for more than 2000 years. It occurs mostly, but not exclusively, in the tropics.
Treatment consists of a special diet of foods that are low in fat and high in protein. Diets free of gluten, a viscid grain protein, may be prescribed. Liver preparations, folic acid, calcium lactate tablets, vitamin B12, and iron supplements to provide food elements that are not absorbed, as well as skim milk and ripe bananas, have produced favorable results. Antibiotics have proved temporarily successful, but their prolonged use is not recommended.
Cases of sprue that are recognized early respond better to treatment than do cases of long standing. Appetite and weight return rapidly. The time required for complete recovery is prolonged, however, especially in extreme cases.
coeliac diseaseA malabsorptive syndrome caused by hypersensitivity of intestinal mucosa to alpha-gliadin, a gluten extract composed of glutamine and proline-rich proteins that is found in wheat, barley, rye, and oats.
Diarrhoea, copious fatty stools, abdominal distension, weight loss, haemorrhage, osteopenia, muscle atrophy, peripheral neuropathy, CNS and spinal cord demyelination (sensory loss, ataxia), amenorrhoea, infertility, oedema, petechiae, dermatitis herpetiformis (especially if HLA B27), alopecia areata. Occult bleeding occurs in half of patients.
Transaminases (ALT, AST) are increased in ± 40% of patients with CD, which usually normalises with a gluten-free diet; iron deficiency, anaemia due to occult bleeding.
Duodenal biopsy; anti-gliadin and anti-endomysial antibodies.
Eliminate gliadin from diet.
Without treatment, 10–15% develop lymphoma (e.g., immunoblastic lymphoma; less commonly, T cell lymphoma), a risk that increases with disease duration. CD predisposes to gastrointestinal lymphoma and carcinoma of the oral cavity and oesophagus; the otherwise rare small intestinal adenocarcinoma is 80-fold more common in CD.
Patient discussion about celiac sprue
Q. Is celiac genetic? I have one son with celiac disease from my first marriage and me second wife is now pregnant,I was wondering what are the chances for this soon to be born daughter of mine to have celiac as well- if I maybe carry the genetic flaw and is there a way to find out?
Q. How do you diagnose celiac? My daughter is 3 years old and is constantly vomiting, has diarrhea and stomach aches. Could this be celiac?
Q. Is FTT a symptom of celiac? My 1.5 year old son has FTT (failure to thrive) and stomach aches. What could be causing it?