Celiac Disease Becoming More Widespread in U.S.
Some urge wider testing to prevent serious health consequences
(HealthDay News) -- It's no accident that your grocer's shelves are more plentifully stocked with gluten-free products.
More Americans are discovering that they cannot tolerate gluten, a protein in wheat, rye and barley, because it damages their digestive system. They have celiac disease, and for them, gluten triggers an autoimmune response that is damaging to the digestive system.
Celiac is often inherited. In others, it's the result of a genetic disorder, such as Down syndrome or Turner syndrome, that increases risk for the disease, according to the U.S. National Digestive Diseases Information Clearinghouse.
Still, celiac disease, also known as sprue, celiac sprue or gluten-sensitive enteropathy, is a bit of a medical mystery and remains widely under-diagnosed.
"Celiac disease has become much more common in the last 50 years, and we don't know why," Dr. Joseph Murray, a Mayo Clinic gastroenterologist, said in a news release from the medical center. "It now affects about one in 100 people."
Murray led a study, published in Gastroenterology, that found that people are four times more likely to have celiac disease today than they were in the 1950s.
During the study's 45-year span, the chances of dying were nearly fourfold greater among people with undiagnosed celiac disease than among those who tested negative for the disorder.
"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," Murray said.
When people with celiac disease consume products containing gluten, their immune system responds by attacking the tiny fingerlike projections, or "villi," in the small intestine, explains the clearinghouse. Without healthy villi, a person cannot absorb key nutrients and, over time, the damage can lead to malnutrition, it says.
Infants and young children with untreated celiac disease may experience such digestive symptoms as abdominal bloating and pain, chronic diarrhea, vomiting, constipation, weight loss and pale, foul-smelling stools.
Adults tend to exhibit a variety of non-digestive symptoms, the most common being iron-deficiency anemia, according to the University of Chicago Celiac Disease Center.
It's also possible to have the disease but have minimal or no symptoms, it says.
Children sometimes have long-term complications from the disease, including failure to thrive in infancy, delayed growth and short stature, delayed puberty and loss of tooth enamel.
Celiac disease can also increase the risk for reduced bone mass in children and osteoporosis in adults, according to the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
For an accurate diagnosis, a person must continue consuming gluten, the Celiac Disease Center explains. Blood tests can reveal the presence of antibodies that suggest gluten intolerance. Testing for the genes responsible for the disease also may be helpful. A small bowel biopsy can confirm the diagnosis and determine the amount of damage to the villi.
Some people with celiac disease develop dermatitis herpetiformis, an itchy, blistering skin rash. If verified through a blood test and skin biopsy, though, an intestinal biopsy should not be needed, according to the clearinghouse, which says that both the skin rash and the digestive disorder should respond to a gluten-free diet.
Experts say that diagnosis is critical because the only treatment is lifelong avoidance of grains containing gluten.
On the Web
To learn more about celiac disease, visit the Celiac Sprue Association.
SOURCES: HealthDay News; Mayo Clinic, news release, July 1, 2009; National Digestive Diseases Information Clearinghouse (www.digestive.niddk.nih.gov); Celiac Disease Foundation (www.celiac.org); University of Chicago Celiac Disease Center (www.uchospitals.edu); National Institute of Arthritis and Musculoskeletal and Skin Diseases (www.niams.nih.gov)
Author: Karen Pallarito
Publication Date: July 31, 2010
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