Sprue means that you cannot absorb nutrients from the food that you eat, causing vitamin and mineral deficiency, diarrhea and cramping. There are two major types of sprue. Celiac sprue means that a component of food called gliadin or gluten causes your own immunity to attack and damage the inner linings of your intestines so that you cannot absorb many components of food. You may also develop a blistery skin rash.

Tropical sprue means that you have an infection that causes the same results. Usually your doctor will draw blood to see if you have antibodies against gliadin and endomysial cells (8), and perhaps biopsy the inner lining of your intestines. Your doctor will test for infection.

Those with celiac sprue are told to avoid foods that contain gliadin or gluten, which is found in wheat, rye and barley. Most recent research shows that most people with celiac sprue can eat oats safely.

It can take more than six months for your intestines to heal with this diet, so most doctors prescribe dapsone or sulfapyridine which usually stops the diarrhea within a few days. You must also be checked for intestinal cancers that are associated with celiac sprue. On the other hand, your blood tests for antibodies to gliadin may be negative and you may continue to have symptoms after taking dapsone or sulfapyridine. You may have an infection called tropical sprue. Not all doctors will treat you with antibiotics, but some may prescribe quinolones or metronidazole. Nutritional deficiencies such as lack of B12, iron, etc. may need to be treated with vitamin and mineral pills.

People who need to avoid the gluten-containing grains can eat rice, corn, wild rice, quinoa and millet. A trial with small amounts of oats can be given. Kamut and spelt are ancient varieties of wheat, and should be avoided. Triticale is a hybrid of wheat and rye which should also be avoided.

For journal references on the studies mentioned in this article see http://www.drmirkin.com/morehealth/G206.htm

Dr. Gabe Mirkin has been a radio talk show host for 25 years and practicing physician for more than 40 years; he is board certified in four specialties, including sports medicine. Read or listen to hundreds of his fitness and health reports at http://www.DrMirkin.com

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