Originally Published: May 23, 2004 7 a.m.
Wheat, barley, rye and oats contain gluten. Those grains may also go by the names spelt, triticale, durum, kamut, einkorn, semolina, seitan, bulger, couscous, tet, graham, malt and buckwheat rye).
The disorder affects the patient's small intestine by causing its cilia (finger-like projections) to lay down, decreasing the amount of intestinal surface area – the body's primary nutrient absorber.
Celiac Spru, Andres said, "drastically reduces (a patient's) ability to absorb nutrients."
He said children with significant cases of Celiac Spru often look "scrawny" and experience diarrhea. A child with the disease "doesn't look good," he said.
Adults who have the disease can acquire osteoporosis or anemia because their bodies aren't absorbing calcium or iron to the extent they should.
"A lot of people don't even know they have it," Andres said.
He said somewhere between one in 100 or one in 200 people have wheat sensitivity but "the majority won't have symptoms."
While many of Celiac Spru's symptoms are similar to those that people experience with irritable bowel syndrome, several symptoms differentiate the two.
People with both disorders may experience bloating, gas and diarrhea, but people with Celiac Spru may develop ulcers in the mouth or a skin rash with small clusters of blisters.
Also, Andres said, doctors can perform blood tests and small bowel biopsies to confirm whether a person has Celiac Spru. While blood tests will show a certain level of the antibodies anti-gliadin and anti-TTA (tissue transglutaminase), the biopsy is the only definitive indicator of whether a person has Celiac Spru.
Most people who have Celiac Spru respond to treatment that consists of a gluten-free diet, Andres said. Those who don't can take prednisone, but that steroid has other long-term side effects, including exacerbating osteoporosis.
Children with Celiac Spru who eat gluten-free often bounce back and catch up with where they should be as far as growth, Andres said.
As with any disease, "there's variation to how sensitive people are to gluten," Andres said. "If (a patient) doesn't have problems with his intestine, there's no need to diet."
A gluten-free diet, Andres said, won't keep a person from ingesting essential nutrients, but "it's just not as fun. We all like wheat products."
Such products, Andres said, include cakes, cookies, bread, pasta and soups.
"Wheat is used in a lot of products," he said.
"The bottom line is that this can be a serious disorder," Andres added. "And it's good that it responds well to dietary management without having to resort to drugs."
But it's not easy, Andres said, to stick to a gluten-free diet.
"Once they start on the diet, they should plan on staying on it for the rest of their lives."
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