In my own practice, I have several patients who have been harmed significantly by treatment for hepatitis C, with outcomes such as chronic sprue-like 'enteropathy' , myopathy, and depression.

Also known as celiac sprue, nontropical sprue and gluten-sensitive 'enteropathy' , celiac disease occurs in people who have a susceptibility to gluten intolerance.

To determine the cause of 'enteropathy' , biopsies of the gastrointestinal tract were performed.

When the diagnosis of gluten-sensitive 'enteropathy' is suspected, serologic tests can identify many affected patients.

Failure to improve while on a gluten-free diet should increase suspicion for other causes of small bowel 'enteropathy' or may indicate noncompliance with the strict diet, which for most patients is difficult to follow.