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Symposium on Steatorrhea
April 6, 1964

Gluten-Free Diet for Nontropical SprueImmediate and Prolonged Effects

Author Affiliations

Durham, NC

From the departments of medicine and pathology, Duke University Medical Center.

JAMA. 1964;188(1):42-44. doi:10.1001/jama.1964.03060270048011

DURING WORLD WAR II Dicke in Holland observed that when bread was scarce or unobtainable, children having celiac disease improved clinically—their diarrhea ceased and they began to gain weight. After the war, when bread became available these same children relapsed.1 Following this clinical observation, Weijers and van de Kamer, utilizing carefully conducted fat balance studies in patients having celiac disease, showed conclusively that by withdrawing flour from the diet the fat content of the stool returned to normal coincident with clinical remission. The addition of flour made from wheat and rye to the diet of these patients resulted in steatorrhea in every case.2 It was shown later that oats had a similar effect and finally that the material responsible was the gliadin fraction of gluten.3 In 1952 McIver in England reported a patient having nontropical sprue who recovered following the administration of the gluten-free diet.4 This

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