ABSTRACT
Celiac disease (also known as celiac sprue or gluten-sensitive enteropathy) is an immune-mediated inflammatory disease of the gastrointestinal tract caused by a permanent sensitivity to wheat, barley and rye. The gluten in wheat and related proteins in barley and rye are degraded into antigenic peptides that trigger an immunologic process that leads to diarrhea, malabsorption and, ultimately, nutritional deficiencies and failure to thrive. There is a description of celiac disease dating back to the 1st century AD, but it was not until the 20th century that the trigger for the disease was identified. Willem Karel Dicke, a Dutch pediatrician, noted that children with celiac disease had a clear improvement in their symptoms during the Second World War when cereals were scarce. After the war and reinstatement of cereals in their diet, children with celiac disease relapsed, and wheat was recognized as the major culprit.
