Hans-Dieter-Belitz-Institute for Cereal Grain Research

Coeliac Disease – A Review

Herbert Wieser

Coeliac disease, also known as coeliac sprue or nontropical sprue, is a disease in humans that is characterised by damage to the small intestinal mucosa and malabsorption. The disease is activated when a susceptible person ingests the alcohol-soluble storage proteins (prolamins) of wheat (gliadins), rye (secalins) and barley (hordeins). The toxic effect of oat prolamins (avenins) remains controversial, whereas proteins from other plants and from animals do not cause coeliac disease. Coeliac-active prolamins lead to a fulminant inflammation of the small intestine, accompanied by the damage of the jejunal villi (see Figure). Consequently, the absorption of important nutritions including iron, calcium and vitamins is strongly reduced. Typical symptoms are chronic diarrhoea, failure to thrive, abdominal distension, vomiting, anaemia or osteoporosis. The commonly accepted basis for diagnosing coeliac disease is a biopsy of the instestinal mucosa and an histological examination. In most cases, a characteristic inflammatory lesion referred to as villous atrophy is found. The only therapy is a strict, long-life so-called gluten-free diet that means, patients have to avoid products from wheat, rye, barley and oats, with the exception of pure starches. The disease is relatively common in Europe being between 1 in 1000 and 1 in 2000. These figures are likely to be underestimated since they refer to typical diagnosed cases; possibly 1 in 200 of the general population is affected. In families, the incidence of coeliac disease is about 10 %.


Normal mucosa		Mucosa of a patient suffering from coeliac disease

Reference: N. K. Harms and W. F. Caspary: Die Zöliakie und Sprue - Zöliakie des Erwachsenen. (Editor.: German Coeliac Society e.V. Filderhauptstraße 61, 70599 Stuttgart.)

Further information: The German Coeliac Society (DZG), Filderhauptstr. 61, D - 70599 Stuttgart, Germany, Phone: +49 711 / 45 99 81 0, Fax: +49 711 / 45 99 81 50, Internet: http://www.dzg-online.de, E-Mail: info@dzg-online.de

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