Celiac disease (sprue) is a fairly common, often inherited condition that frequently goes undiagnosed. Patients with this disease have difficulty absorbing nutrients and vitamins due to inflammation of the lining of the small intestine (see picture). Foods that contain barley, wheat and rye cause this malabsorption, and symptoms include abdominal pain, fatigue, diarrhea, weight loss, bloating, gas, rash (dermatitis herpetiformis), depression, anxiety, numbness in the extremities and/or bone pain. Over time, patients with undiagnosed and untreated celiac disease often develop osteoporosis because of the difficulty absorbing calcium and vitamin D. Milk sensitivity, known as lactose intolerance, frequently occurs. Lymphoma, or lymph node cancer, seems to be more common as well.
Diagnosis is usually made through blood tests, with confirmation obtained by biopsy of the lining of the small intestine. This is usually done with a scope that looks at the upper digestive tract (upper endoscopy). It is very important that a patient eat as he/she normally would while getting these tests, because a gluten-free diet may alter the results. Treatment is centered around avoiding food that contain barley, wheat and rye. This is known as a gluten-free diet, and is frequently difficult to do, because many dishes contain these grains. There are a number of resources to assist a patient in becoming gluten-free, including works by Betty Hagman. She has personal experience with celiac disease, and has authored helpful books on the subject including:
The Gluten-Free Gourmet: Living Well Without Wheat
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Richard R Samuel, MD Family Practice and Urgent Care Hayden, ID USA