celiac disease [Gk, koilia + L, dis, opposite of; Fr, aise, ease] , an inborn error of metabolism characterized by the inability to hydrolyze peptides contained in gluten. Gluten is found in wheat, oats, and barley. Also called celiac sprue, gluten-induced enteropathy, nontropical sprue. Compare malabsorption syndrome. ▪ OBSERVATIONS: The disease affects adults and young children, who suffer from abdominal distension, vomiting, diarrhea, muscle wasting, and extreme lethargy. A characteristic sign is a pale, foul-smelling stool that floats on water because of its high fat content. ▪ INTERVENTIONS: Most patients respond well to a high-protein, high-calorie, gluten-free diet. Rice and corn are good substitutes for wheat, and any vitamin or mineral deficiencies can be corrected with oral preparations. ▪ PATIENT CARE CONSIDERATIONS: There may be a secondary lactose intolerance, and it may become necessary to eliminate all milk products from the diet. Prognosis for full recovery is excellent. Failure to respond generally indicates misdiagnosis.
