What is Gluten Enteropathy?

Gluten enteropathy is a condition in which the body’s immune system recognizes a protein called gluten as a harmful substance. The immune system then becomes sensitized to some of the body’s own proteins because they resemble the gluten protein. Each time someone with this disease eats food containing gluten, the immune system mounts a response to the gluten and to the body proteins that resemble it. These body proteins are found on tiny structures called villi, which are responsible for absorbing nutrients in the small intestine. Gluten enteropathy is also called gluten-sensitivity enteropathy and is more commonly known as celiac disease.

Symptoms of gluten enteropathy fall into one of two categories: symptoms because of malabsorption and symptoms because of malnutrition. Symptoms of malabsorption are caused by the reduced ability of the digestive system to correctly process and absorb proteins, fats and carbohydrates. Possible symptoms include diarrhea, bloating, foul-smelling flatulence and fatty or greasy stools.

One of the most potentially harmful consequences of gluten sensitivity is nutrient malnutrition. Absorption of fatty acids, fat soluble vitamins and some water-soluble vitamins can be reduced in someone with celiac disease. Deficiencies in vitamins A, D, K and E, as well as several B vitamins, folic acid and a large number of essential minerals, are common.

Gluten enteropathy is primarily a disease of the digestive system, because the typical route of exposure to gluten is through ingestion. Even so, many other bodily systems are affected by gluten sensitivity, largely as a result of nutrient malnutrition. Unexplained weight loss, muscle weakness, anemia, blood clotting abnormalities, dermatitis, osteoporosis, thyroid disease, diabetes, depression, anxiety, chronic fatigue, arthritis, fertility and pregnancy problems and even digestive cancers are all associated with celiac disease.

The pattern of symptoms can differ slightly in adults and children. Generally, adults are less likely than children to have fatty or greasy stools and diarrhea and are less likely to have multiple nutrient deficiencies. Children tend to be more affected by nutrient deficiencies, sometimes to the point where physical development falls behind that of their peers.

Tests used to diagnose gluten enteropathy involve the use of immunological testing to detect blood antibodies to certain body proteins. Someone with the antibodies in their blood has immune cells that have been sensitized to these proteins. Not all people with these antibodies have noticeable symptoms of celiac disease, however.

Some people who test positive for celiac disease antibodies have very few or no symptoms, even if they eat gluten regularly. These people are said to have latent or silent celiac disease. They might remain symptom-free for the remainder of their lives, but physical stress might at some point trigger the immune system and cause symptoms to appear.

There are no medications or surgical procedures that can treat celiac disease. The only treatment is to completely remove all sources of gluten from the diet. This protein is found in wheat, rye and barley, so all three of these grains must be eliminated. Many people who have been diagnosed with gluten enteropathy find it beneficial to work with a dietitian or nutritionist to modify their diet to accommodate these new restrictions.