Celiac disease is an autoimmune disease that is triggered when a person eats gluten.  An autoimmune disease occurs when the body starts  to attack normal tissue, as if an infection were present.  Celiac disease has been known by many different names, including gluten-sensitive enteropathy, gliadin sensitive enteropathy, and celiac sprue (to differentiate it from
tropical sprue).

 In celiac disease, there is a permanent intolerance gluten,  the gliadin fraction of wheat protein and related alcohol-soluble proteins (called prolamines) found in rye and barley.  Celiac disease occurs in genetically susceptible individuals who eat these proteins.  This
condition self-perpetuates as long as these food products are in the diet.  This results in the malabsorption of critical vitamins, minerals, and
calories. Signs and symptoms of the disease classically include diarrhea, short stature, iron-deficiency anemia and lactose intolerance.  Patients may present with another autoimmune disease (such as type I diabetes), or a family history of the disease, with no gastrointestinal symptoms. 

Serum antibodies can be measured with a blood test  to screen for celiac disease. However, the key to confirming the diagnosis remains a small intestinal biopsy, combined with the person's response to a gluten-free diet. Physicians in the United States must maintain a high index of suspicion for this disease, as  it is significantly under-diagnosed in this country.