Coeliac disease
Coeliac disease – the chameleon of gastroenterology
Coeliac disease (formerly known as celiac sprue) is an autoimmune disease triggered by the consumption of gluten in genetically predisposed individuals and characterised by gluten-sensitive enteropathy of the small intestine. In affected individuals, the consumption of gluten, even in trace amounts, leads to an immune reaction in the intestine with villous atrophy. These histopathological changes can result in malabsorption syndrome.
What is villous atrophy?
The small intestine mucosa is lined with villi and fine protrusions called microvilli. These serve to increase the surface area and improve nutrient absorption. In affected individuals, the small intestine villi and microvilli have almost completely regressed. This can be detected during diagnosis by means of a small intestine biopsy. The damage and flattening of the small intestine mucosa means that fewer or no nutrients can be absorbed. The consequences include malnutrition and deficiency symptoms.
Why is coeliac disease considered the "chameleon of gastroenterology"?
Coeliac disease is also known as the "chameleon of gastroenterology". This is because the autoimmune disease manifests itself with a wide variety of intestinal and extraintestinal symptoms and sometimes remains asymptomatic. Due to its varied symptoms, many cases remain undetected or misdiagnosed for several years.
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Read moreSources
- Felber, J., Bläker, H., Fischbach, W., Koletzko, S., Laaß, M.W., Lachmann, N., Lorenz, P., Lynen, P., Reese, I., Scherf, K., Schuppan, D. & Schumann, M. (2021). Updated S2k guideline on coeliac disease from the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS). Consultation version October 2021