The nature and implication of intestinal endocrine cell changes in coeliac disease.

Coeliac disease is associated with intestinal lesion. This lesion causes architectural derangement of the mucosa in the form of villus atrophy, increased crypt length and increased volume of the lamina propria. Several changes in the intestinal endocrine cells have been reported over the years, e.g. the number of secretin cells and increased numbers of GIP, CCK/gastrin, motilin, and serotonin cells. There is no consensus about the nature of the changes in somatostatin-cells. It has been postulated that the changes in the endocrine cells are a selective process to meet the new demands exerted by the dramatic decrease in intestinal absorptive area. It has been speculated further that the changes in the endocrine cells would cause an incomplete digestion of the ingested food and its rapid elimination from the intestine. These changes may be responsible for the diarrhoea and steatorrhoea that occur in patients with coeliac disease.