Celiac disease, or gluten-sensitive enteropathy, is an autoimmune disease resulting in maldigestion and malabsorption of nutrients when patients are exposed to gliadin, the alcohol-soluble portion of gluten. Gluten is commonly found in wheat-, rye-, and barley-containing foods. Ingestion of gluten leads to intestinal lymphocyte infiltration with crypt hyperplasia and blunting of intestinal villi, leading to symptoms of malabsorption.

The prevalence of celiac disease is approximately 1% in the United States population, and risk is increased in those with type 1 diabetes, trisomy 21, thyroid disease, Turner syndrome, or a family history of celiac disease in a first-degree relative.

Common clinical presentation includes foul-smelling chronic diarrhea, steatorrhea, flatulence, bloating, post-prandial abdominal pain, and weight loss. Children may present with failure to thrive or with deviations from their growth curve. Other extraintestinal manifestations include iron deficiency anemia, dermatitis herpetiformis, weakness, amenorrhea, and osteopenia / osteoporosis. Celiac disease can also present as an otherwise unexplained elevation in liver function tests (alanine transaminase [ALT] and aspartate transaminase [AST] primarily), fat-soluble vitamin deficiency (vitamins A, D, E, and K), and copper deficiency. Rarely, patients have had adrenal insufficiency associated with celiac disease.