Celiac Disease Bowel Patterns

Two classic signs for Celiac Sprue malabsorption are:

Moulage Sign (tube of wax) - In severe cases, the jejunum can appear as a tube with no visible folds, resembling a smooth "cast" or mold due to total villous atrophy.

Fold Reversal - the jejunum loses its folds to look like a normal ileum, and the ileum simultaneously gains folds to mimic a normal jejunum. The criteria is < 3 folds/inch in jejunum; > 4-6 folds/inch in ileum.