What is the most common symptom in untreated celiac disease (sprue)?

Updated: Nov 29, 2019
  • Author: Stephan U Goebel, MD; Chief Editor: BS Anand, MD  more...
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Diarrhea is the most common symptom in untreated celiac disease and is present in 45-85% of all patients. Diarrhea caused by celiac disease is due to the maldigestion and malabsorption of nutrients. The stools might be watery or semiformed, light tan or gray, and oily or frothy. The stools have a characteristic foul odor. In infants and young children, extensive diarrhea can lead to severe dehydration, electrolyte depletion, and metabolic acidosis.

Note that Sartans are angiotensin II receptor blockers (ARBs) (eg, olmesartan, losartan, valsartan). Several reports indicate that these drugs, particularly olmesartan, can cause severe diarrhea, weight loss, and villous atrophy, findings that can mimic celiac disease (sprue). [16, 17, 18, 19]  Therefore, sartan-induced diarrhea should be included in the differential diagnosis for celiac disease.

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