Celiac disease - sprue Health Article

Definition

Celiac disease is an inherited, autoimmune disease in which the lining of the small intestine is damaged from eating gluten and other proteins found in wheat, barley, rye, and possibly oats.

Alternative Names

Sprue; Nontropical sprue; Gluten intolerance; Gluten-sensitive enteropathy

Causes, incidence, and risk factors

The exact cause of celiac disease is unknown. The intestines contain projections (called villi) that absorb nutrients. In undiagnosed or untreated celiac disease, these villi become flattened. This affects the ability to absorb nutrients properly.

The disease can develop at any point in life, from infancy to late adulthood.

Those with a family member with celiac disease are at greater risk for developing the disease. The disorder is most common in Caucasians and those of European ancestry. Women are affected more commonly than men.

There are numerous diseases and conditions associated with celiac disease, including:

• Anemia
• Autoimmune disorders such as rheumatoid arthritis and systemic lupus erythematosus
• Certain types of intestinal cancer
• Dermatitis herpetiformis
• Down syndrome
• Lactose intolerance
• Miscarriage or unexplained infertility
• Neurological conditions
• Osteoporosis or osteopenia
• Thyroid disease
• Type 1 diabetes

Symptoms

The symptoms of celiac disease can vary significantly from person to person. This is part of the reason the diagnosis is frequently delayed. For example, one person may have constipation, a second may have diarrhea, and a third may have no irregularity in stools.

A partial listing of gastrointestinal symptoms:

• Abdominal pain
• Abdominal distention, bloating, gas, indigestion
• Constipation
• Decreased appetite (may also be increased or unchanged)
• Diarrhea, chronic or occasional
• Lactose intolerance (common upon diagnosis, usually goes away following treatment)
• Nausea and vomiting
• Stools that float, are foul smelling, bloody, or “fatty”
• Unexplained weight loss (although people can be overweight or of normal weight upon diagnosis)

A partial listing of nonintestinal symptoms:

• Anemia (low blood count)
• Bone and joint pain
• Bone disease (osteoporosis, kyphoscoliosis, fracture)
• Breathlessness (due to anemia)
• Bruising easily
• Dental enamel defects and discoloration
• Depression
• Fatigue
• Growth delay in children
• Hair loss
• Hypoglycemia (low blood sugar)
• Irritability and behavioral changes
• Malnutrition
• Mouth ulcers
• Muscle cramps
• Nosebleed
• Seizures
• Short stature, unexplained
• Skin disorders (dermatitis herpetiformis)
• Swelling, general or abdominal
• Vitamin or mineral deficiency, single or multiple nutrient (for example, iron, folate, vitamin K)