Celiac disease (sprue)

Alternative names:

celiac sprue; gluten enteropathy; nontropical sprue; sprue

Symptoms:

IN INFANTS AND CHILDREN

• abnormal stools
• diarrhea
• growth, slow (child 0 to 5 years old)
• irritability
• stools, bloody
• stools, clay colored
• vomiting
• weight loss
• decreased appetite (anorexia)
• stools - foul smelling
• muscles in arms and legs are thin and wasted
• abdominal distention

IN ADULTS

• abnormal appearance of the teeth
• abdominal distention
• abdominal pain
• bloating
• bone pain
• bone tenderness
• breathlessness (due to anemia)
• depression
• diarrhea
• fatigue
• irritability
• muscle cramps
• tiredness
• vomiting
• weight loss

Additional symptoms that may be associated with this disease:

• nosebleed - symptom
• swelling, overall
• stools - floating

Signs and tests:

Typically, most persons with celiac disease will have symptoms of malabsorption. However, some will have bone disease, anemia, or other conditions without diarrhea. Compression fractures of the back, kyphoscoliosis (see scoliosis), or other signs of bone disease may be present. Steatorrhea ("fatty" diarrhea, stools may also be foul smelling and unusual colored) is often present.

Dental examination may show changes in the teeth. In fact, some cases of celiac disease are suspected by the dentist because of the changes in the enamel of the teeth, which include symmetrical (the same on both sides) changes in the tooth color and surface texture.

A CBC often indicates anemia. An EGD (endoscopy) and small bowel biopsy, particularly biopsy of the jejunum (the part of the small intestine most often affected), will show an abnormal intestinal lining. Serial biopsies may be performed before and after a gluten-free diet. Improvement of the findings of biopsy (or improvement of symptoms) after a gluten- and gliadin-free diet is considered highly indicative of celiac disease.