Ten patients who had nontropical sprue but had been kept relatively free from symptoms by adhering to a gluten-free diet were studied with respect to the functional capabilities of the small intestine. The gluten-free diet is known to improve the nutritional status, but the improvement has not been accepted as denoting complete recovery. The laboratory and roentgenographic findings in this series indicated general improvement of intestinal function, but none of the patients had completely normal digestion and assimilation. The most consistent abnormal finding was steatorrhea both before and during the investigation. Azotorrhea persisted in two patients, and abnormal tolerance curves for glucose and vitamin A were present in eight. The fundamental intestinal disturbances, other than gluten intolerance, that cause nontropical sprue remain to be determined.
Green PA, Wollaeger EE, Scudamore HH, Power MH. NONTROPICAL SPRUE: FUNCTIONAL EFFICIENCY OF SMALL INTESTINE AFTER PROLONGED USE OF GLUTEN-FREE DIET. JAMA. 1959;171(16):2157–2162. doi:10.1001/jama.1959.03010340001001
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