Celiac Disease, Part 1

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  • Celiac disease affects roughly 3 million Americans, which averages out to be about 1 in 133 healthy people.
  • In individuals with a first degree relative with celiac disease, the prevalence drops to 1 in 22, and in those with a 2nd degree relative, it affects 1 in 39 people.
  • The number of people with celiac disease in the U.S. would fill 4,400 Boeing 747 airplanes.
  • The number of people with celiac disease in the U.S. is roughly equal to the number of people living in the state of Nevada.
  • U.S. fans with celiac disease could fill Soldier Field, the home of the Chicago Bears, 37 times.

Did you know that May is Celiac Disease Awareness month? Although this is only recognized in a handful of states, New Hampshire, North Carolina, Maryland, Minnesota, Illinois, and California, awareness about celiac disease has spread. However, more knowledge is needed, as getting an accurate diagnosis is very difficult. It is commonly misdiagnosed as IBS, Crohn’s disease, ulcerative colitis, or many other various conditions. According to the University of Chicago Celiac Disease Center, 41% of adults and 60% of children diagnosed were asymptomatic and it takes an average of four years for a symptomatic individual to be correctly diagnosed with celiac disease. This makes me wonder how long it takes an asymptomatic individual to be correctly diagnosed or someone who does not have the “usual” symptoms associated with celiac disease such as gas, bloating, and/or diarrhea. During this time without a correct diagnosis, individuals are at increased risk of other autoimmune disorders, osteoporosis, neurological disorders, and possibly cancer.

So what exactly is celiac disease…? Individuals with celiac disease are allergic to proteins (glutenin and gliadin) found in wheat and relative wheat products (kamut, triticale, durum, spelt, semolina, farro, graham), rye, and barley. Upon ingestion of foods containing gluten, an immune-mediated toxic reaction occurs causing destruction of the villi in the small intestine. With atrophy of the villi, malabsorption of nutrients occurs including calcium, iron, zinc, and vitamin K, along with the fat-soluble vitamins. With continued ingestion of gluten containing products, malnutrition can set in, along with other disorders including intestinal lymphoma and bowel cancer, lactose intolerance, osteoporosis, anemia, bone and joint pain, iron deficiency, vomiting, constipation, diarrhea, depression, anxiety, neurological complications, miscarriages (and congenital problems in an unborn baby), and weight loss and failure to thrive in children.

Oats may be problematic in some individuals as crops that grow wheat are cleared out and then oats are grown leading to cross-contamination. However, you can purchase certified gluten-free oats at various grocery stores. It’s best to test the oats and see how well you tolerate them. If you feel that you have any symptoms re-emerge, remove them from your diet. Over time, as your GI tract heals, you may be able to reintroduce them again.

Next to come, gluten-free grains!

References:

Green PHR, Stavropoulos SN, Panagi SG, Goldstein SL, Mcmahon DJ, Absan H, Neugut AI. Characteristics of adult celiac disease in the USA: results of a national survey. Am J Gastroenterol. 2001;96(1):126-131.

Holmes S. Celiac disease: Symptoms, complications and patient support. Nurs Stand. 2010;24:50-56.

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