Celiac Disease

Celiac disease (sometimes known as celiac sprue or gluten intolerance) is a genetic, or hereditary, disease. The ingestion of gluten (found in wheat, barley, rye, and possibly oats) results in an immune response that causes damage to the small intestines and inhibits absorption of certain important nutrients.

Children with celiac disease have symptoms that can include chronic diarrhea, bloating, anemia, and failure to grow at a normal rate. Early intervention is key to preventing damaging complications of this disease, especially in childhood cases. There is a genetic predisposition to developing celiac disease, and a large majority of patients have at least one copy of a gene called HLA-DR3.

In order to estimate incidence of the disease in the general population, researchers conducted a large genetic screen of over 22,000 newborns in Denver, Colorado. A subset of the infants were followed for 5 years to compare disease development in those having zero, one, or two copies of the susceptibility gene. Overall, roughly 1% (1 in 100) of all children at age 5 were estimated to have the disease. The children who had either one or two copies of the susceptibility gene were at an increased risk compared to children without the gene. In addition, the researchers found that females had a higher risk for disease development than males.[1]

These results show that celiac disease is common in a population representative of the general population, and new screening strategies based on the study may help identify children at increased risk. Interestingly, other new studies have been revealing that onset or clinical symptoms of celiac disease is not restricted to children.

From

NIDDK Recent Advances & Emerging Opportunities: Digestive Diseases and Nutrition. February 2004.

In the U.S., there may be a general lack of knowledge about the disease among many physicians. Some of the symptoms are similar to, but distinguishable from, those found in other disorders such as IBS, Crohn's disease, ulcerative colitis, diverticulosis, intestinal infections, chronic fatigue syndrome, and depression.

The disease can also be present without apparent symptoms, but can still lead to complications. Celiac disease can be diagnosed with a blood test to measure the level of antibodies to gluten. A biopsy of the small intestine is generally the most effective way to diagnose celiac disease. A biopsy may also be done, if it appears that celiac disease is present, to look for tissue damage.

Eliminating gluten from the diet is the treatment for celiac disease. This usually results in rapid improvement of symptoms and healing of the intestines. Gluten is a common ingredient in many foods including most grain, pasta, and cereal foods as well as many processed foods. Strict adherence to a gluten-free diet can be a challenge. There are several organizations to support people with celiac disease, including:

• The Celiac Disease Foundation (818-990-2354);
• The Celiac Sprue Association (402-558-0600);
• The Gluten Intolerance Group (206-246-6652); and
• The American Celiac Society Dietary Support Coalition (973-325-8837).