🌾 Villous Atrophy Healing (Marsh Classification) Simulator

Marsh IIIc — Total Villous Atrophy

Placeholder: gluten-driven flattening destroys the absorptive villous surface.

• ~0%: Villous height (Placeholder short note)
• Max: Crypt depth (Placeholder short note)
• High: IELs (Placeholder short note)
• Severe: Symptom load (Placeholder short note)

Baseline severe damage

Placeholder: flattened mucosa with dense lymphocytic infiltrate at baseline.

Placeholder: diagnosis stage before diet change begins.

Partial Atrophy — Early Structural Rebuild

Placeholder: blunted villi start regaining modest height.

• ~30%: Villous height (Placeholder short note)
• High: Crypt depth (Placeholder short note)
• 1–3 mo: Timeframe (Placeholder short note)
• Moderate: Symptom load (Placeholder short note)

Early structural rebuild

Placeholder: shortened villous stubs emerge after gluten exclusion.

Placeholder: earliest histologic sign of healing response.

Early Recovery — Villous Elongation

Placeholder: villous stubs lengthen while lymphocytes remain elevated.

• ~55%: Villous height (Placeholder short note)
• Elevated: Crypt depth (Placeholder short note)
• 3–9 mo: Timeframe (Placeholder short note)
• Mild: Symptom load (Placeholder short note)

Villous elongation phase

Placeholder: progressive lengthening restores partial absorptive surface.

Placeholder: lymphocyte counts lag behind structural repair.

Crypt Hyperplasia Resolving

Placeholder: crypt depth ratio normalizes as turnover slows.

• ~80%: Villous height (Placeholder short note)
• Falling: Crypt depth (Placeholder short note)
• 9–18 mo: Timeframe (Placeholder short note)
• Minimal: Symptom load (Placeholder short note)

Crypt-villus ratio recovery

Placeholder: crypt hyperplasia declines toward the normal ratio.

Placeholder: ratio normalization tracks mucosal healing closely.

Complete Villi Recovery

Placeholder: tall finger-like villi and normal crypts restored.

• 100%: Villous height (Placeholder short note)
• Normal: Crypt depth (Placeholder short note)
• 12–24 mo: Timeframe (Placeholder short note)
• Resolved: Symptom load (Placeholder short note)

Full mucosal normalization

Placeholder: histology matches a gluten-naive healthy mucosa.

Placeholder: full recovery timing varies by patient age.