Celiac disease, also referred to as celiac sprue or gluten-sensitive enteropathy, is a chronic disorder that is readily recognized when it presents in its classical form with diarrhea, bloating, flatulence, weight loss and evidence of malabsorption. Withdrawal of immuno-genic grains including wheat, rye and barley from the diet of affected patients results in a rapid clinical improvement and a slower return of small bowel histology to normal. Over the past two decades it has become increasingly evident that celiac disease can present in many other ways including non-specific gastrointestinal complaints, anemia, recurrent miscarriages, neuropsychiatric disorders and osteopenic bone disease . In addition, celiac disease may complicate other disorders, particularly autoimmune endocrine and connective tissue diseases. Celiac disease is a unique disorder representing both a form of food allergy and an autoimmune disease. Until relatively recently, celiac disease was thought to be rare and primarily a disease of childhood, even a disease that one could grow out of. As will be discussed it is now recognized the celiac disease is common, affecting both adults and children, and is a lifelong condition that is treated almost exclusively by dietary measures.
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