Celiac Disease
(Gluten
Enteropathy)
Medical Author:
Dennis Lee, M.D.
Medical Editor:
Jay W. Marks, M.D.
What is celiac disease?
Celiac disease is a disease of the small intestine. The small intestine
is a 22 foot long tube that begins at the stomach and ends at the large intestine (colon). The first
1-1/2 feet of the small intestine (the part that is attached
to the stomach) is called the duodenum, the middle part is called the jejunum,
and the last part (the part that is attached to the colon) is called the ileum. Food
empties from the stomach into the small intestine where it is digested and
absorbed into the body. While food is being digested and absorbed, it is
transported by the small intestine to the colon. What enters the colon is
primarily undigested food. In celiac disease, there is an immunological (allergic)
reaction within the inner lining of the small intestine to proteins (gluten) that are present in wheat,
rye, barley and, to a lesser extent, in oats. The immunological reaction causes
inflammation that destroys the lining of the small intestine. This reduces the
absorption of dietary nutrients and can lead to
symptoms and signs of nutritional, vitamin, and mineral deficiencies. Other
names for celiac disease include sprue, nontropical sprue, gluten enteropathy, and
adult celiac disease. (Tropical sprue is another disease of the small intestine
that occurs in tropical climates. Although tropical sprue may cause symptoms
that are similar to celiac disease, the two diseases are not related.)
Celiac disease is common in European countries,
particularly in Ireland, Italy, Sweden, and Austria. In Northern Ireland, for
example, one in every 300 people has celiac disease. In Finland, the prevalence may be as high as one in every 100 persons. Celiac disease also occurs in
North America where the prevalence
has been estimated at one in every 3000 people. Unfortunately, most population
studies underestimate the prevalence of celiac disease because many patients who
develop celiac disease have few or no symptoms until later in life. In fact, a
recent study in the United States suggests that the prevalence of celiac disease
in the United States is similar to Europe.
Next: What causes celiac disease? »
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