Causes
Celiac sprue results from a combination of immunological responses to an environmental factor (gluten) and genetic factors. Both genetic predisposition and exposure to gluten are necessary for the development of celiac sprue.
Immune Mechanisms
The interaction of gliadin (a specific gluten found in certain grain products) with the lining of the small intestine is crucial in celiac sprue development. When individuals with celiac sprue consume gluten-containing foods, gliadin triggers an immune response. The body produces antibodies called antigliadin antibodies, which target gliadin.
Additionally, two other antibodies are present in people with celiac disease: endomysium antibodies, targeting a small intestinal smooth muscle component, and tissue transglutaminase antibodies, targeting an enzyme. These autoantibodies indicate the involvement of autoimmunity in the disease process of celiac sprue. Genetic factors also play a significant role, with celiac disease occurring more frequently in relatives of affected individuals.
Celiac sprue can be debilitating, especially if not diagnosed early. Individuals with symptoms or a family history of the disease are advised to seek medical advice. Since celiac sprue is hereditary, close family members of affected individuals should also be tested. Pregnant females with worsening anemia should seek medical care, as celiac sprue might be a factor in worsening anemia during pregnancy.
Self-Care at Home
Effective control of celiac sprue primarily involves modifying the diet and selecting suitable foods. Various resources are available to assist individuals in choosing appropriate foods and adapting recipes to their diet.
It's crucial to read food labels carefully, as wheat, rye flours, barley, and oats are common ingredients in many products. Surprising products like salad dressings may contain these ingredients. Substitutions can be made, such as using rice flour and rice-based bread, cornstarch for thickening, and sorghum as an alternative.
Outlook
Celiac sprue typically shows improvement within days of starting a gluten-free diet. Complete healing of the small intestine usually occurs within 3-6 months, although it might take up to 2 years in older individuals.