Wednesday, July 1, 2009

Celiac Disease Much More Common Today

Celiac disease is an immune system reaction to gluten in the diet, and according to new research from the Mayo Clinic, it is now over four times more common than it was 50 years ago. The original Mayo research was published in the journal Gastroenterology.

It was also reported in this study that subjects who did not know they had celiac disease were nearly four times more likely than celiac-free subjects to have died during the 45 years of follow-up.

Joseph Murray, M.D., the Mayo Clinic gastroenterologist who led the study, says "Celiac disease has become much more common in the last 50 years, and we don’t know why. It now affects about one in a hundred people. We also have shown that undiagnosed or ‘silent’ celiac disease may have a significant impact on survival. The increasing prevalence, combined with the mortality impact, suggests celiac disease could be a significant public health issue.”

I'm sure you've seen, as I have, an increasingly large selection of "gluten free" products on the shelves at health food stores, and often at large chain groceries as well. This can only be due to an increasing number of aware patients in the marketplace.

In patients with celiac disease, the presence of a protein called gluten from wheat, barley or rye triggers an immune system attack, damaging the villi in the small intestine. Villi are fingerlike projections that increase the intestine’s surface area for nutrient absorption. Celiac disease symptoms may include diarrhea, abdominal discomfort, weight loss, anemia, unexplained infertility, loss of teeth or even premature or severe osteoporosis.

Researchers at the Mayo found that young people today are 4.5 times more likely to have celiac disease than young people were in the 1950's. "It’s no longer rare,” says Dr. Murray. “Something has changed in our environment to make it much more common. Until recently, the standard approach to finding celiac disease has been to wait for people to complain of symptoms and to come to the doctor for investigation. This study suggests that we may need to consider looking for celiac disease in the general population, more like we do in testing for cholesterol or blood pressure.”

Dr. Murray says the study findings highlight the need for increased awareness of celiac disease, both among physicians and patients. “Part of the problem is that celiac disease symptoms are variable and can be mistaken for other diseases that are more common, such as irritable bowel syndrome,” he says. “Some studies have suggested that for every person who has been diagnosed with celiac disease, there are likely 30 who have it but are not diagnosed. And given the nearly quadrupled mortality risk for silent celiac disease we have shown in our study, getting more patients and health professionals to consider the possibility of celiac disease is important.”

Dave

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