Rate of celiac disease is growing

Working to solve the puzzle of when people develop celiac disease has led researchers from the University of Maryland School of Medicine Center for Celiac Research to some surprising findings. They have found that the autoimmune disorder is on the rise with evidence of increasing cases in the elderly. An epidemiological study published September 27 in the Annals of Medicine supports both trends—with interesting implications for possible treatment and prevention.

“You’re never too old to develop celiac disease,” says Alessio Fasano, M.D., director of the University of Maryland’s Mucosal Biology Research Center and the celiac research center, which led the study. The Universita Politecnica delle Marche in Ancona, Italy; the Johns Hopkins Bloomberg School of Public Health; the Women & Children’s Hospital of Buffalo; and Quest Diagnostics Inc. of San Juan Capistrano, Calif., also participated.

Celiac disease is triggered by consuming gluten, a protein found in wheat, barley and rye. Classic symptoms include diarrhea, intestinal bloating and stomach cramps. Left untreated, it can lead to the malabsorption of nutrients, damage to the small intestine and other medical complications.

Since 1974, in the U.S., the incidence of the disorder has doubled every 15 years. Using blood samples from more than 3,500 adults, the researchers found that the number of people with blood markers for celiac disease increased steadily from one in 501 in 1974 to one in 219 in 1989. In 2003, a widely cited study conducted by the celiac research center placed the number of people with celiac disease in the U.S. at one in 133.

As the people in the study aged, the incidence of celiac disease rose, echoing the findings of a 2008 Finnish study in Digestive and Liver Disease that found the prevalence of celiac disease in the elderly to be nearly two and a half times higher than the general population. The recent findings challenge the common speculation that the loss of gluten tolerance resulting in the disease usually develops in childhood.

“You’re not necessarily born with celiac disease,” says Carlo Catassi, M.D., of the Universita Politecnica delle Marche in Italy. Dr. Catassi is the lead author of the paper and co-director of the Center for Celiac Research. “Our findings show that some people develop celiac disease quite late in life.” The trend is supported by clinical data from the center, notes Dr. Catassi, who urges physicians to consider screening their elderly patients.

Although researchers have identified specific genetic markers for the development of celiac disease, exactly how and why an individual loses tolerance to gluten remains a mystery. “Even if you have these genetic markers, it’s not your destiny to develop an autoimmune disease,” adds Dr. Fasano. “Our study shows that environmental factors cause an individual’s immune system to lose tolerance to gluten, given the fact that genetics was not a factor in our study since we followed the same individuals over time.”

The finding contradicts the common wisdom that nothing can be done to prevent autoimmune disease unless the triggers that cause autoimmunity are identified and removed. Gluten is one of the triggers for celiac disease. But if individuals can tolerate gluten for many decades before developing celiac disease, some environmental factor or factors other than gluten must be in play, notes Dr. Fasano.

Identifying and manipulating those factors could lead to novel treatment and possible prevention of celiac disease and other autoimmune disorders including type 1 diabetes, rheumatoid arthritis and multiple sclerosis. Researchers at the University of Maryland Center for Celiac Research are working toward that goal, says Dr. Fasano. As the third most common disease category after cancer and heart disease, autoimmune disorders affect approximately five to eight percent of the U.S. population, according to the National Institutes of Health.

“The groundbreaking research of Dr. Fasano and his team sheds new light on the development of celiac disease, a complex disorder that continues to present challenges to physicians and their patients,” says E. Albert Reece, M.D., Ph.D., M.B.A, vice president for medical affairs, University of Maryland, and John Z. and Akiko K. Bowers Distinguished Professor and dean, University of Maryland School of Medicine.

Diagnosis of celiac disease can be a challenge as patients who test positive for the disease may not display the classic symptoms of gastrointestinal distress linked to the disease. Atypical symptoms include joint pain, chronic fatigue and depression. In the study, only 11 percent of people identified as positive for celiac disease autoimmunity through blood samples had actually been diagnosed with the disease.

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7 thoughts on “Rate of celiac disease is growing”

  1. I have yet to see anything that links the rise in Celiac with the rise in the use of toxic and poisonous additives to most processed foods, especially those with wheat and other gluten bearing ingredients. Look at bread, the FDA still allows the addition of potassium bromate, a known toxin and carcinogen that has been banned in just about every other industrialized country in the world. The list of additives put into processed foods grows every year, as does the incidence of Celiac and other diseases. Will we ever learn the truth? Is it possible to ever know the truth? The real truth about all of these toxins will never be allowed to be known as so much money is made by the companies that make them. Scary,
    Chef Roy http://www.choose-eat-live-well.blogspot.com

  2. The rising amount of people being diagnosed with celiacs disease is a bit of a concern, but I’m sure when more research is made available people with these types of food problems will be able to leave a higher quality of life.

    Great article by the way


    Spencer :-)

  3. Dr. O has some useful information.
    However, he is trying to sell you something that is of no use in detecting Celiac disease and that is genetic testing.

    Please ensure that you know all the facts before spending (wasting) your money on this! Thirty percent of the population will have the “celiac genotype”.

  4. As with any autoimmune disease environmental factors actually play a huge role and it won’t get science anywhere by neglecting to consider it. While genetic is obviously a factor, as is processed foods environmental factors do play a role in how CD can be displayed. I for one suffered undiagnosed for 8 years before getting a diagnosis, my symptoms were the worst when my environmental factors were the worst and I can tell you that obviously my genetics didn’t change over time nor did my consumption of processed food. I do agree however that the cost of goods is preposterous and not at all appropriate.

  5. We continue to see more and more information on celiac disease and gluten sensitivity, but as the comment above mentions, little is coming out on the whole picture. The focus continues to be marketers trying to convince people to buy unhealthy “gluten free” items at exaggerated costs. Unfortunately, the cardinal rule of nutrition will always prevail. One cannot get healthy or stay healthy eating unhealthy foods.

    Now that the media attention is hard focused on the topic, the scientific community has lifted their proverbial heads out of the sand. Researchers are working on a vaccine for celiac disease. As if diet changes weren’t cure enough.

    All the best,
    Dr. Osborne

    • Thanks for your reply. I visited your web site and WOW! My daughter, who is probably a celiac disease poster child (as I’m deducing with no help from the medical establishment) went “gluten-free” manufactured food (so we did not have alter habits/likes much), but it did not good. And from the testimonials, etc, I see our mistake is a common one. I’ll be digging through everything, but thanks for sharing so much information.

      But, I was surprised how many commenters on the page you cited would take the drugs. Like the drugs for depression (which I’m concluding is most often a gluten sensitivity issue), the long-term effects would probably be a disaster. Rather than discourage consumption of toxic grains (or even correctly ferment them, etc.), big pharma just sees more opportunity to profit from sickness (rather than provide the info needed to avoid it).

      Celiac disease, when all is said and done, is not a defect in the people, but in the food (and the greed-based health care model). Good grief … it is so obvious when you can see thru the fog.

  6. What an incredible demonstration of the disinformation from the corporatocracy. Environmental factors, again? They could not suspect the increased gluten in today’s wheat varieties? Or the rapid manufacturing processes that avoid time consuming fermentation that neutralize the toxins?

    Wheat sensitivity (i.e., subclinical celiac disease) is probably the #1 cause of depression, heart disease, obesity, etc., in the U.S. (although fructose and vegetable oils are contenders). But saying that could hurt health establishment profits. Never the truth.

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