Sheila E Crowe MD

Contents

1 Introduction

2 Epidemiology

3 Spectrum of Clinical Presentations and Associated Conditions

4 Non-Specific Gastrointestinal Symptoms and Other Non-Malabsorptive Presentations

5 Pathogenesis

6 Diagnosis of Celiac Disease

7 Strategies for Confirming a Diagnosis

8 Complications of Celiac Disease

9 Mortality Associated with Celiac Disease

10 Non-Responsive and Refractory Celiac Disease

11 Risk of Malignancy in Celiac Disease

12 Management Issues in Celiac Disease

13 Screening for Celiac Disease

14 Prevention of Celiac Disease

15 Conclusion

From: Clinical Gastroenterology: Nutrition and Gastrointestinal Disease Edited by: M.H. DeLegge © Humana Press Inc., Totowa, NJ

Summary

Celiac disease, also known 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. However, non-gastrointestinal GI and non-specific GI manifestations are currently the more common presentations of this disease. Withdrawal of gluten from the diet results in a rapid clinical improvement and a slower but corresponding return of normal small bowel histology. Inappropriate T-cell responses to ingested gluten in genetically predisposed individuals result in the intestinal injury that characterizes celiac disease. The discovery that tissue transglutaminase (tTG) is a target of the immune response in celiac sprue has led to the development of new diagnostic tests. With the increasing numbers of celiacs being identified in the USA and elsewhere, it is important that physicians and other health care providers continue to be educated about this disorder including recent developments in the field.

KeyWords: Malabsorption, Diarrhea, Autoimmunity, Food allergy, Iron deficiency, Osteopenic bone disease, Intestinal biopsy, Serological tests, Gluten-free diet

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