Celiac Disease: What Dietitians Can Do to Effectively Treat a Growing Problem

The symptomology of celiac disease, also known as gluten-sensitive enteropathy or celiac sprue, was first described in AD 50 by Aretaeus, a noted ancient Greek physician who specialized in isolating and explaining disease states. Clinical manifestations of the disease were distinctly defined by Samuel Gee in 1888 who theorized that diet therapy was likely the treatment for the disease: the allowance of farinaceous must be small, but if the patient can be cured at all, it must be by means of diet. Farinaceous foods included those rich in starches or mealy in texture. Treatment at the time consisted of a dietary regimen of rice, bananas, and cream. Approximately 60 years later, a Dutch pediatrician named Willem Carol Dicke, isolated gluten as the toxic fraction and cause of the enteropathy associated with the disease. This discovery was made with the coinciding rise and fall of hospitalizations caused by celiac disease and the fluctuation in bread and wheat rationing during World War II. In the 1980s, the causative factor of celiac disease was further determined to be an allergy to the gliadin fraction of gluten. Until recently, the disease was classified as a malabsorption disorder in children; it is now recognized to occur at any age and onset of symptoms may occur in individuals that are 50 to 60 years of age