Studies from the United States, Europe, and elsewhere indicate that the prevalence of celiac disease (CD) has increased significantly in the last 3 decades - possibly by as much as a factor of 4.
Researchers at the Mayo Clinic report the increase has affected young and old people. It suggests something has happened in a pervasive fashion from the environmental perspective. Not only is the mortality raised in patients with [CD] but also in those individuals with latent [CD]. It can be asymptomatic; have so-called traditional symptoms such as diarrhea, weight loss, failure to grow (in children), fatigue, and malnutrition; and have nontraditional symptoms such as osteoporosis, depression, adverse pregnancy outcome; and increased risks of both malignancy and death. The onset of certain autoimmune disorders including autoimmune liver disease, thyroid disease, type 1 diabetes, and Addison's disease can actually signal CD. This means that clinicians should consider CD in a number of symptoms and disorders because to this point, in most countries, at least two thirds of individuals with CD have not received a diagnosis by a doctor.
At this time, researchers said, the gluten-free diet remains the cornerstone of treatment for CD. However, in the future, alternative treatment strategies may be available. The recent discovery of the structure of transglutaminase 2 may help in designing inhibitors of transglutaminase 2 to treat CD. There is also ongoing research on the topic of decreasing the bowel's permeability to gluten. However, the safety and efficacy of these approaches are unclear.
Finally, agricultural research may mean that we can modify the gluten structure in wheat to produce a kind of wheat that will not illicit an immune response in patients with CD.
Counseling patients about gluten-free diets is critical. In patients with CD who do not become better on a gluten-free diet, the most common reason is probably that the patients do not eat a strictly gluten-free diet. According to Mayo researchers, it is not enough to say,"you've got CD, be gluten-free, goodbye. CD requires follow-up."
Bonnie - Why would anyone be surprised about the rise in celiac in the US? Wheat is in everything. The wheat lobby's coup, getting the USDA to recommend that Americans eat 3 or more servings of whole grains daily (whole wheat in particular, which has the highest gluten content of any food), assures that celiac will continue to be on the rise.