Gluten Allergy: Celiac Sprue

A funny, outdated-sounding but serious medical problem, celiac sprue, now called celiac disease, affects 1 in every 100 U.S. citizens. Yet, 97% of the population remains undiagnosed. (McKinley, CSACeliacs.org)

The inability to eat wheat gluten is the common description most people are familiar with. Technically celiac disease is not a disease but the body’s auto-immune system attacking the wheat protein (also known as gluten) found in such items as whole wheat, rye, and barley.

It sounds simple but is tough to diagnose. The longer the diagnosis is unmade, the more celiac disease starts to mimic other diseases, thus complicating a final diagnosis. Some of the signs and symptoms “out of a possible 300 for celiac disease” (CSAceliac.org) include chronic fatigue, some cancers, diabetes, chronic diarrhea, chronic constipation, and migraine headaches, just name a few.

But the mystery doesn’t end here. Jill Crissman, 59, Doctor of Veterinary Medicine, discovered her celiac disease via a dermatology problem. Her symptoms included itchy, blistering, burning skin rashes that started from blisters. Her dermatologist diagnosed Jill with dermatitis herpetiformus found in 10% of celiac disease population. “I presented myself with lesions on several places on my body,” Jill explained.

These kept her awake at night and did not respond to traditional medications. “Celiac disease is basically the destruction of epithelial cells in the body,” Jill points out. Most often the disease is diagnosed with first a blood test looking for sensitivity followed by an endoscopic exam. (Done in the hospital with insertion of medical device down to the upper GI where several villi of the small intestine are clipped to inspect for destruction.)

“Celiac disease dates back to the 'fertile crescent' region of Eastern Europe when wheat crops were first grown and harvested for food,” continues Jill with historical facts. “People with the gene that essentially made them allergic to wheat gluten died in those times. Now we know the remedy is complete avoidance of all food stuff made with the offending protein.”

Over 3 million people have celiac disease. Twenty-six-year-old Katherine Binder was diagnosed at 19. After a life of serious infections, constant fatigue, stomachaches and intestinal issues, and finally a second diagnosis of severe anemia, she got a firm diagnosis. Her sister, father and mother were required to take the blood test for sensitivity to the offending protein. They were all found negative.

It’s quite possible Binder's grandfather suffered his whole life with celiac disease. He complained constantly of stomach issues and tiredness. Since knowledge of this disease process has only been around for the past 40-50 years, many sufferers have never had work-ups for celiac disease.

Celiac disease can start at any age, including in the elderly, and may be triggered by a gastrointestinal or viral infection, severe stress, surgery or pregnancy. Many individuals have “silent celiac disease” (i.e., have no or very subtle symptoms) in spite of gluten sensitivity. (Case, 15) 

Jill gives a concise explanation of celiac disease. “It is the body’s auto- immune system attacking the protein (collectively known as gluten) in wheat, rye, barley causing the destruction of the epithelial cells in different parts of the body; we can’t call this a true disease process.”

The tough part about diagnosing celiac disease is that it mimics other diseases. Plus “continued exposure to gluten can result in vitamin and mineral deficiencies, causing conditions such as anemia, osteoporosis, neurological disorders, and an increased risk for developing other autoimmune disorder (e.g., thyroid disease, type 1 diabetes) and certain types of cancers, just to name a few.” (Case, 15)

The word celiac refers to the abdominal cavity of the body. Sprue, an out-of-date expression from the 1820s, is a chronic disease, occurring chiefly in the tropics. (The American Heritage Medical Dictionary.) Current research debunks this fact as the disease is most prominent in Northern Europe. Even the word disease is not technically correct.

Works Cited

Case Nutrition Counseling. April, 2006. Book

Crissman, Jill, personal interview, August 25, 2011

McKinley, Mary. “Celiac Disease – Defined.” CSACeliacs.org. 09, September, 2011

"sprue." The American Heritage® Stedman's Medical Dictionary. Houghton Mifflin Company. 12 Sep. 2011. 

Pamella Binder is a freelance writer specializing in health topics. In her next  column, she will discuss celiac disease  treatment options and resources.

© Pamella Binder, 2011