Q: My brother is 34 years old and weighs 50 kg. He experiences pain in his stomach and his digestion is also not proper. He goes to the toilet many times during the day. The gastroenterologist advised endoscopy. The report says: Circopharynx: shows normal mucosa; Esophagus: shows normal mucosa; junction is at 40 cm; lumen is normal. No evidence of ulceration; Stomach: fundus shows normal muscosa. No varices seen, body shows normal mucosa, antrum shows normal mucosa, pylorus shows normal mucosa; Duodenum: d1 shows normal mucosa. Lumen is normal; Impression: F/S/O malabsorption syn; Biopsy taken: Yes for hisptopathology. The doctor advised for a blood test called anti ETG, the report of which is awaited. The doctor says that my brother has gluten allergy and he should avoid wheat and other gluten substances. We are in a state of confusion. Can this allergy be detected even before the biopsy report? If my brother has this allergy, then what is the cure?

A:Celiac sprue (or gluten-sensitive enteropathy) is a chronic disorder of the gastro-intestinal tract, which interferes with the digestion and absorption of food nutrients. Patients have an allergy to a protein called gluten (found in wheat, rye, barley, etc) which results in an immune reaction affecting the lining of the intestines causing diarrhoea, malabsorption, flatulence etc. The diagnosis is made on the basis of the findings on small intestinal biopsy plus the presence of IgA & IgG antigliadin antibodies and IgA antibody to endomysium. Treatment is avoidance of food items containing flour and corticosteroids.