Celiac sprue and related diseases

Opinion statement  

–	Celiac sprue may be as common as 1:250 among persons of Western European heritage. The presentation is often subtle. Many cases are unrecognized. Physicians must be familiar with the various manifestations of celiac sprue and screen for it appropriately.
–	The treatment of celiac sprue is a gluten-free diet. However, it is difficult to follow a strict gluten-free diet for life. Patients benefit from referral to expert dietitians and to support groups.
–	Refractory sprue, ulcerative jejunoileitis, and enteropathy-associated T cell lymphoma are related to celiac sprue, but do not respond to a gluten-free diet. Immunosuppressive therapy has been used for these conditions, but complications are common.