This is a damage to the intestinal wall caused by grain protein from wheat, rye, barley and oats (gluten). In the course of the disease, the villi are destroyed to varying degrees and there is a reduced absorption of nutrients through the intestinal wall.
Often, the enzyme lactase, which degrades lactose, is also often absent, and in most cases fats are excreted in the stool (steatorrhea).
The appearance of the native Sprue varies in size and ranges from an extreme food abuse and lack of supply of severe diarrhea to uncharacteristic complaints in the digestive tract.
Since cereal proteins of the above-mentioned cereals are known to cause the disease, sprue therapy consists of consistently eliminating these foods and keeping a gluten-free diet.
The proteins from corn and rice and the pure starch from wheat, rye, oats and barley do not have any effect on disease.
In practice, the following must be observed: Apart from the pure starch, all products from wheat, rye, barley and oats should be avoided.
This not only means that the patient must avoid bread, rolls, cakes, semolina, barley, noodles, etc., ie foodstuffs whose production and compositions are generally known. But it must not consume foods for which the addition of cereal products, especially flour, is not so obvious.
These are in particular manufactured by the food industry finished products such as soups, sauces, canned food, some sausages, cocoa-containing drinks and much more. There is a particular danger of eating cereal protein while eating in restaurants and canteens.
Under strictly gluten-free diets, the symptoms completely disappear for most people affected.
Lifelong, consistent avoidance of gluten-containing foods (from and with wheat, rye, barley, oats) and substitution by rice, corn, sweet chestnuts and pure wheat starch (very sensitive patients, however, still react to the slightest traces of gluten in pure wheat starch).
Adapting the diet to the respective different damage to the intestinal wall such as in fatty stools reduce the fat intake or avoid lactose deficiency lactose (in the disease "lactose intolerance") described.
In the early stages of treatment, it is advisable to avoid foods rich in oxalic acid, especially if no dairy products are available.
These are first and foremost:
Oxalic acid combines with calcium to form water-insoluble calcium oxalate, so it can not be absorbed and calcium deficiency is exacerbated.
For stubborn stools, MCT grease can also be used. MCT fats and their use are described in detail in the chapter "Condition after stomach operations".
As the digestive capacity of the small intestinal mucosa improves, fats and milk sugar can be consumed in normal amounts again. However, avoiding gluten will be necessary for life.
Products specially made for the gluten-free diet. They are marked with a criss-crossed ear and are available mainly from specialist retailers or health food stores.
Important notes on the composition of a product may provide the list of ingredients required for packaged foods. However, gluten is increasingly being added to food for technological reasons and then appears only under the declaration "vegetable protein product".
Detailed information on the diet of native Sprue is also available from the Deutsche Zöliakiegesellschaft e. In Stuttgart.
During the symptom-free phase, without fat restriction, no lactose intolerance.
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