Celiac Sprue

Celiac Sprue is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • Celiac sprue consists of chronic inflammation of proximal small bowel mucosa from an immunologic sensitivity to gluten (protein found in wheat, barley, and rye), resulting in malabsorption of dietary nutrients. The condition remains incompletely recognized and underdiagnosed.1
  • Clinical presentation can vary greatly from asymptomatic iron deficiency anemia to significant diarrhea and weight loss. Other presenting features can include osteoporosis, dermatitis herpetiformis, abnormal liver enzymes, and abdominal pain; incidental recognition at endoscopy can also occur.2
  • More than 7% of patients with nonconstipated IBS have celiac-associated antibodies, suggesting that gluten sensitivity may trigger symptoms resembling IBS.3

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