Celiac disease in a patient with morbid obesity

A 28-year-old woman was morbidity obese and subsequently underwent a jejunoileal bypass. Routine intraoperative small-bowel biopsy disclosed jejunal villous atrohpy. Nine months later, she had lost more than half her body weight and experienced severe diarrhea and vomiting. When a gluten-free diet was instituted, her symptoms regressed, and the jejunal mucosa returned to normal. The necessity of considering celiac disease in cases of prolonged diarrhea occurring after various types of bowel surgery is emphasized.