Diagnosis of coeliac sprue in 1994

The first accurate clinical description of coeliac sprue was made more than a century ago. This disease entity could be defined and objectively diagnosed only after its relationship to gluten intake was discovered and jejunal biopsy techniques were developed to demonstrate the typical "flat" small intestinal mucosa. Since then clinical and histopathologic improvement on gluten-free diet has remained a cornerstone for the diagnosis of coeliac sprue; however, controversies regarding the diagnostic criteria had existed. This article presents the clinical features and the major categories of investigation for the diagnosis of coeliac sprue.