Celiac sprue. Diagnosis and diet: keys to recovery.
Celiac sprue is a devastating disease that can have fatal consequences if untreated. Fortunately, if diagnosed correctly and promptly, it can be effectively treated with very satisfactory outcomes. A careful history will often suggest the diagnosis, but definitive diagnosis requires finding the typical lesion on small bowel biopsy and clinical improvement with a gluten-free diet. If symptoms and mucosal abnormalities persist, glucocorticoids should be tried. Malignancy is a rare complication of longstanding CS that should be looked for if there is no response to gluten withdrawal or if symptoms relapse despite adherence to diet.
Schutz
S M
SM
Department of Internal Medicine, Duke University Medical Center, Durham 27710.
Stroebel
J
J
Schutz
E M
EM
Leaseburge
L
L
Baillie
J
J
D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy / Q000473:pathology; D006801:Humans; D007421:Intestine, Small / Q000473:pathology