1. Celiac Disease or Sprue By Clo Mudrik

2. Celiac disease - Sprue Sprue; Nontropical sprue; Gluten intolerance; Gluten-sensitive enteropathy Celiac disease is a condition that damages the lining of the small intestine and prevents it from absorbing parts of food that are important for staying healthy The damage is due to a reaction to eating gluten, which is found in wheat, barley, rye, and possibly oats.

3. Causes, incidence, and risk factors The exact cause of celiac disease is unknown. The lining of the intestines contains areas called villi, which help absorb nutrients. When people with celiac disease eat foods or use products that contain gluten, their immune system reacts by damaging these villi. This damage affects the ability to absorb nutrients properly. A person becomes malnourished, no matter how much food he or she eats. The disease can develop at any point in life, from infancy to late adulthood. People who have a family member with celiac disease are at greater risk for developing the disease. The disorder is most common in Caucasians and persons of European ancestry. Women are affected more often than men.

4. People with celiac disease are more likely to have: Autoimmune disorders such as rheumatoid arthritis, systemic lupus erythematosus, and Sjogren syndrome Addison's disease Down syndrome Intestinal cancer Intestinal lymphoma Lactose intolerance Thyroid disease Type 1 diabetes

5. Symptoms ( the symptoms can be different from person to person. This is part of the reason why the diagnosis is not always made right away!) Gastrointestinal Symptoms: Abdominal pain, bloating, gas, or indigestion Constipation Decreased appetite (may also be increased or unchanged) Diarrhoea, either constant or off and on Lactose intolerance (common when the person is diagnosed, usually goes away after 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)

6. Because the intestines do not absorb many important vitamins, minerals, and other parts of food, the following symptoms may start over time: Bruising easily Depression or anxiety Fatigue Growth delay in children Hair loss Itchy skin (dermatitis herpetiformis) Missed menstrual periods Mouth ulcers Muscle cramps and joint pain Nosebleeds Seizures Tingling or numbness in the hands or feet Unexplained short height

7. Children with celiac disease may have: Defects in the tooth enamel and changes in tooth color Delayed puberty Diarrhea, constipation, fatty or foul-smelling stools, nausea, or vomiting Irritable and fussy behavior Poor weight gain Slowed growth and shorter than normal height for their age

8. Signs and tests Albumin(may be low) Alkaline phosphatase (high level may be a sign of bone loss) Clotting factor abnormalities Cholesterol(may be low) Complete blood count (CBC- test for anemia) Liver enzymes (transaminases) Prothrombin time

9. Treatment Gluten Free Diet! Look for support groups! Lots of Information at internet!

10. Complications delaying diagnosis or not following the diet puts you at risk for related conditions such as: Autoimmune disorders Bone disease (osteoporosis, kyphoscoliosis, fractures) Certain types of intestinal cancer Low blood count (anemia) Low blood sugar (hypoglycemia) Infertility or repeated miscarriage Liver disease

11. Prevention Because the exact cause is unknown, there is no known way to prevent the development of celiac disease However, being aware of the risk factors (such as having a family member with the disorder) may increase your chances of early diagnosis, treatment, and a long, healthy life.

12. Allowed Foods Amaranth Arrowroot Buckwheat Cassava Corn Flax Indian rice grass Job’s tears legumes Millet Nuts Potatoes Quinoa Rice sago Seeds Sorghum Soy Tapioca Wild rice Yucca Foods To Avoid Wheat einkorn, emmer, spelt, kamut Wheat starch, wheat bran, wheat germ, cracked wheat, hydrolysed wheat protein Barley Rye Triticale (a cross between wheat and rye) Other Wheat Products Bromated flour Durum flour Enriched flour Farina Graham flour Phosphate flour Plain flour Self-rising flour Semolina White flour Processed Foods that May Contain Wheat, Barley, or Rye* Bouillon cubes Brown rice Syrup Candy Chips/potato chips Cold cuts, hot dogs, salami, sausage wafers French fries Gravy imitation fish matzo rice mixes saucesseasoned tortilla chips self-basting turkey soups soy sauce vegetables in sauce * Most of these foods can be found gluten-free. When in doubt, check with the food manufacturer.

13. Other Wheat Products Bromated flour Durum flour Enriched flour Farina Graham flour Phosphate flour Plain flour Self-rising flour Semolina White flour Processed Foods that May Contain Wheat, Barley, or Rye* Bouillon cubes Brown rice Syrup Candy Chips/potato chips Cold cuts, hot dogs, salami, sausage wafers French fries Gravy imitation fish matzo rice mixes saucesseasoned tortilla chips self-basting turkey soups soy sauce vegetables in sauce

14. Points to remember: People with celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. Untreated celiac disease damages the small intestine and interferes with nutrient absorption. Without treatment, people with celiac disease can develop complications such as osteoporosis, anemia, and cancer. A person with celiac disease may or may not have symptoms. Diagnosis involves blood tests and, in most cases, a biopsy of the small intestine. Since celiac disease is hereditary, family members of a person with celiac disease may wish to be tested. Celiac disease is treated by eliminating all gluten from the diet. The gluten-free diet is a lifetime requirement. A dietitian can teach a person with celiac disease about food selection, label reading, and other strategies to help manage the disease.