Coeliac sprue

Shan, L., Marti, T., Sollid, L.M., Gray, G.M., and Khosla, C. 2004. Comparative biochemical analysis of three bacterial prolyl endopeptidases Implications for coeliac sprue. Biochem J 383(2) 311-318. 

Malabsorption has many causes. Some malabsorptive disorders, for example coeliac sprue, impair the absorption of most nutrients, vitamins and trace minerals (global malabsorption) others, for example pernicious anaemia, are more selective. Pancreatic insufficiency causes malabsorption if >90% of function is lost. Increased lumen acidity (e.g. Zollinger-Ellison syndrome) inhibits lipase and fat digestion. Cirrhosis and cholestasis reduce hepatic bile synthesis or delivery of bile salts to the duodenum, causing malabsorption. Some causes are summarised in Table 4.2. 

F14. Frazer, A. C., Disordered gastro-intestinal function and its relationship to tropical sprue, coeliac disease and idiopathic steatorrhoea. Trans. Boy. Soc. Trop. Med. Hyg. 46, 576 (1952). 

Chronically abnormal epithelium Amyloidosis Coeliac disease Crohn s disease Ischaemia Radiation enteritis Tropical sprue Whipple s disease... 

Cellier C, Delabesse E, Helmet C, et al. Refractory sprue, coeliac disease, and enteropathy-associated T-cell lymphoma. French Coeliac Disease Study Group. Lancet. 2000 356 203-208. 

The inadequate intake of riboflavin seems to be the main cause for the deficiency of this vitamin, being common in populations whose diet lack dairy products and meat, and in anorexic individuals. Digestion and intestinal absorption disorders are other causes of disability, as observed in individuals with lactose intolerance, tropical sprue, coeliac disease and intestinal resection, as well as gastrointestinal and biliary obstruction. Other disorders such as diarrhoea, infectious enteritis and irritable bowel syndrome can cause poor absorption by increasing intestinal motility. Riboflavin deficiency also occurs in conditions such as chronic alcoholism, diabetes mellitus and inflammatory bowel diseases. 

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