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 The actual proportion of people with celiac disease in the United
States has not changed since 2009, researchers say.
“The total prevalence is stable,” Dr. Joseph Murray told Reuters
Health in a phone interview. But there are fewer people walking
around with “hidden” celiac disease.
“When you look at the proportion that are diagnosed versus
undiagnosed, that's gone up dramatically. Go back six years and most
patients were undiagnosed, with only about one in five getting
diagnosed,” said Murray, a gastroenterologist at Mayo Clinic in
Rochester, Minnesota who was part of the study team.
“This increase in proportion diagnosed could be a reflection of
increasing awareness of celiac disease,” said Murray.
It's also possible that people are getting the diagnosis more
readily due to more wide use of testing, he said.
Celiac disease is an autoimmune disorder that affects roughly one of
every 100 people in the U.S. People with celiac disease must avoid
foods that contain the gluten protein from wheat, barley or rye;
otherwise, their immune system attacks their intestines, resulting
in malnutrition and a host of other problems.
As reported in Mayo Clinic Proceedings, Murray and his colleagues
examined data from the large National Health and Nutrition
Examination Surveys, also known as NHANES, from 2009 to 2014.
Altogether, they had information, including blood test results, on
more than 22,000 participants over the age of six.
On average, about 0.7 percent of the study population had been
diagnosed with celiac disease throughout the study period. The
proportion of undiagnosed cases of celiac disease dropped in half
during that time, from 0.6 percent to 0.3 percent.
As has been reported before, the proportion of participants who
followed a gluten-free diet without a celiac diagnosis jumped from
0.5 percent in 2009 to 1.7 percent in 2014.
Murray said the research wasn’t designed to show why gluten-free
diets became a trend, because when they planned the study almost ten
years ago, there really wasn't a fashion for being gluten free.
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“That has now changed. In fact, that's changed dramatically. Now
(when people) feel something wrong with them, they think, ‘Oh it
could've been food,’ (and) one of the first things they'll think
about is gluten,’” Murray said.
Murray sees nothing wrong with following a gluten free diet when
patients don’t have celiac disease, but he thinks they need to be
open to the possibility that it's not going to work.
“Try it but do it for a month and be honest in terms of ‘do I feel
dramatically better and if I do, is it still dramatically better a
month and then two months later,’” Murray said. “If it doesn't work
and it doesn't stay working, don't keep at it. And then if it does
keep working, then try a gluten challenge and see what happens to be
certain that gluten is a real culprit.”
Dr. Benjamin Lebwohl, the director of clinical research at The
Celiac Disease Center at Columbia University in New York, told
Reuters Health the findings are a departure from the longstanding
problem of having many undiagnosed patients.
Lebwohl, who wasn’t involved in the study, said by email, “The
numbers of patients are small, and this was only observed in the
most recent two-year period, but if confirmed it may mark a turning
point in our efforts to increase awareness and identify patients
with celiac disease.”
SOURCE: http://mayocl.in/2iF0r0t Mayo Clinic Proceedings, online
December 22, 2016.
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