The Celiac Sprue Association has an excellent web site covering all aspects of this condition. Dr. Joe Galati will tonight review the most common features of this condition.

Celiac disease (CD) is a genetically linked disease with an enviornmental trigger. In people with CD, eating certain types of protein fractions, commonly called gluten, set off an autoimmune response that causes damage to the small intestine. This, in turn, causes the small intestine to lose the ability to absorb the nutrients found in food, leading to malnutrition and a variety of other complications.

The offending protein, gluten, is found in wheat, barley, rye, and to a lesser extent, oats (WBRO). Related proteins are found in triticale, spelt, kamut. Refer to grains and flours Glossary for a more extensive list of both safe and offending grains.


Celiac Disease is:

  • an inherited disease. Celiac disease effects those with a genetic predisposition.
  • linked to genetically transmitted histocompatibility cell antigens (HLA DR3-DQ2, DR5/7 DQ2, and DR4-DQ8). Other genetic links are being discovered.
  • COMMON. Approximately 1 in 133 people have CD, however, only about 3% of these have been diagnosed. This number is based upon a milestone multi-center study of blood samples collected from 13,145 people from February 1996 to May of 2001. This means that there were over 2.1 million undiagnosed people with celiac disease in the United States in 2001.
  • characterized by (IgA mediated) damage to the mucosal lining of the small intestine which is known as villous atrophy.
  • responsible for the malabsorption of nutrients resulting in malnutrition.
  • linked to skin blisters known as dermatitis herpetiformis (DH).
  • not age-dependent. It may become active at any age.

Celiac Disease is NOT:


  • simply a food allergy (IgA).
  • an idiosyncratic reaction to food proteins (mediated by IgE).
  • typified by a rapid histamine-type reaction (such as bronchospasm, urticaria, etc.).