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The following article appeared in the St. Louis Post-Dispatch today,
10/3/02.

Dr. Paul Donohue : Gluten-free diet is the cure for celiac sprue patients

By Dr. Paul Donohue


Dear Dr. Donohue: My mother, 63, has been diagnosed with celiac sprue
after months of constant diarrhea. She has been told that her villi are
so severely destroyed that it is unlikely they will recover, even if she
adheres to her strict diet. Will her body be able to absorb nutrients? Is
there any encouragement I can offer her?

Celiac sprue is an amazingly common disorder that is, amazingly,
diagnosed only after years of symptoms. It's the result of the digestive
tract's susceptibility to gluten, a protein found in wheat, rye and
barley. Some patients are also sensitive to oats.

Gluten, in a susceptible person, disrupts the architecture of the small
intestine, the place where nutrients are absorbed. It flattens intestinal
villi, hair-like projections from the small intestine's lining. Villi are
essential for food absorption.

The result is diarrhea. Weight plunges. Fatigue, abdominal cramps and
bloating are other symptoms. Vitamin deficiencies are common because of
the small intestine's inability to absorb nutrients.

A gluten-free diet almost assures restoration of villi and a return to
normal food and vitamin absorption. So successful is it that lack of
improvement on the diet can indicate a lapse in following the diet or a
misdiagnosis.

A gluten-free diet is not one easy to follow. It is no trouble to avoid
foods with the offending grains when the food is obviously the product of
one of those grains. It is big trouble to avoid gluten in foods where no
one suspects it might be: some ice creams and salad dressings, for
example. A nutritionist or dietitian is best equipped to instruct a
patient on the celiac sprue diet. Eighty percent of patients see their
symptoms vanish after two months on the diet. Ten percent take a bit
longer, and the final 10 percent must wait two years for results.

Contact the Celiac Disease Foundation on the Internet at www.celiac.org,
or call 818-990-2354.

ADVICE - Readers may write Dr. Donohue or request an order form of
available health newsletters at P.O. Box 536475, Orlando, Fla.
32853-6475.

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