Celiac endoscopy findings8/17/2023 ![]() A mucosal inflammatory response is evident that extends from the duodenum into the more distal small intestine for variable distances. Often the disorder presents clinically with diarrhea, malabsorption of one or more nutrients, and resultant weight loss. CD has been characterized as an immune reaction to gluten-containing proteins found in different but related grains, including wheat, rye and barley. Future studies need to take into account the individual nature of the normal mucosal healing process in CD treated with a gluten-free diet.Ĭeliac disease (CD), previously labeled celiac sprue or gluten-sensitive enteropathy, has been defined as an immune-mediated enteropathy that develops in genetically-susceptible persons ( 1). Changes are not only time-dependent, but appear to be gender-dependent with resolution more readily achieved in females compared to males, and age-dependent with more persistence of the inflammatory process in the elderly compared to younger patients. In CD, resolution of histopathological changes can occur within 6 months, but often, more than a year is required, and sometimes, 2 years or more. In some patients, this mucosal inflammatory process may persist, especially in the proximal small intestine for variable periods of time. With a gluten-free diet, these changes can be expected to resolve to normal. Small intestinal biopsies from the duodenum reveal a severe to moderately severe architectural disturbance showing crypt epithelial hyperplasia with increased numbers of epithelial cell mitotic figures along with villous “flattening”, increased numbers of lamina propria plasma cells and lymphocytes and increased numbers of intra-epithelial lymphocytes in untreated disease. Serological studies also tend to normalize. In most, clinical features improve with resolution of diarrhea and weight loss. Celiac disease (CD) is an immune-mediated enteropathy that characteristically responds to treatment with a gluten-free diet. ![]()
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