Genetics plays a significant role when it comes to the diseases we get or do not get in our lifetime. Among those that are determined by genetics, is celiac sprue, which affects the autoimmunity of the small bowel. Research has shown that an estimated 1% of patients come from Indo-European origins, although the disease still remains to be largely underdiagnosed.

Because symptoms are not enough in clearly determining celiac sprue, patients have to undergo a number of tests to rule out other diseases. However, if the patient does not consume gluten, the tests are not useful anymore. They will need to consume some gluten, about 10 grams a day, for a certain period of time in order to complete the studies. Blood tests are also helpful in diagnosing celiac sprue. Serology is a common tool in determining if a patient has celiac sprue, but this is only prior to an endoscopy needed to verify the results. A biopsy follows the endoscopy in order to fully confirm the overall results and rule out any other disease. Both the endoscopy and biopsy are done for the duodenum, although the severity of the affected parts vary.

Symptoms of celiac sprue vary and sometimes make it difficult to diagnose those with the disease. In children, failure to thrive is a common symptom, but in all ages, diarrhea, weight loss, and fatigue also seem to be present. However, it must be noted that the symptoms are not always consistent and there may be a complete absence of all symptoms in some patients who have celiac sprue. In some cases, the symptoms are associated with the body’s functioning to absorb nutrients, or other symptoms that are not related to bowel problems. Children less than 2 years old exhibit symptoms that closely identify bowel and growth problems not long after they have consumed gluten products. Adults with a mild celiac sprue commonly have anemia or fatigue.

The body’s reaction gliadin, a wheat-based gluten protein, is the cause of celiac sprue. It must be noted that this is not the same as a wheat allergy. During the reaction, transglutaminase, an enzyme tissue, changes the protein, and also causes the immune system to cross-react with the tissue of the bowel, resulting in inflammation. The reaction also constricts the absorption of nutrients in the small intestine, because the inflammation causes the lining to thin out.