The antiendomysial antibody test is the most specific. The degree of microscopic damage varies from mild inflammation to complete blunting or atrophy of the finger like projections called villi. The treatment of celiac sprue is to remove all gluten from the diet. Even small amounts of gluten can prevent a clinical response. It is important for the patient to become very familiar with gluten free products.
Information is available in celiac disease support groups as well as a web page for celiac disease.
Some patients may not respond to a gluten free diet and need other treatment, such as steroids. Patients on gluten free diets should have supplements of vitamins, particularly vitamin D, folic acid, and iron. These may need to be given by injection if they cannot be absorbed in the oral form. Rarely, patients with celiac sprue have developed tumors of the esophagus and small bowel. Patients may also develop multiple ulcers in the small bowel with stricturing and intestinal obstruction.