More cases of celiac disease, especially among seniors

More cases of celiac disease, especially among seniors

Researchers were surprised to find that the incidence of celiac disease is rising, especially among seniors, according to a report published in the Annals of Medicine, September 27 issue. The investigators say their findings have interesting implications for prevention and possible treatment.

The consumption of gluten, a protein found in some cereals, such as barley, rye and wheat triggers celiac disease in susceptible individuals, giving them diarrhea, stomach cramps and intestinal bloating. If left untreated the patient's body may not absorb nutrients properly; the condition can eventually damage the small intestine.

Alessio Fasano, MD, director of the University of Maryland's Mucosal Biology Research Center and Center for Celiac Research, which led the study, said:

You're never too old to develop celiac disease

Celiac disease incidence has doubled in the USA every 15 years since 1974, the authors inform.

The number of individuals with celiac disease blood markers rose from 1 in 501 in 1974 to 1 in 219 in 1989, according to blood samples taken from over 3,500 adults. A 2003 study revealed that the incidence had risen to 1 in every 133 people.

The researchers found that the incidence (or risk) of celiac disease rises with age, confirming a 2008 study carried out in Finland which revealed that elderly people are twice as likely to develop the disease compared to the general population.

The common speculation that gluten intolerance develops in childhood appears to be challenged by these findings.

Lead author, Carlo Catassi, MD, co-director of the Center for Celiac Research, the Universita Politecnica delle Marche, Italy, said:

You're not necessarily born with celiac disease. Our findings show that some people develop celiac disease quite late in life.

Castassi urges doctors to consider screening elderly patients too.

Nobody really knows how and why a patient loses gluten tolerance, even though scientists have identified specific genetic markers for its development.

Farsano adds:

Even if you have these genetic markers, it's not your destiny to develop an autoimmune disease. 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 authors say their findings challenge the common theory that unless the triggers that cause autoimmunity are identified and removed, nothing can be done to prevent autoimmune disease.

Gluten is definitely one the celiac disease triggers, but probably not the only one, Fasano writes. If an individual has been able to tolerate gluten for several years before developing celiac disease, there must be an environmental factor involved.

If those factors can be detected and manipulated, it could be the first step toward novel therapies and potential prevention of several autoimmune disorders, including celiac disease, diabetes Type 1, multiple sclerosis or rheumatoid arthritis, the investigators believe.

E. Albert Reece, MD, PhD, MBA, 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, wrote:

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.

Sometimes accurately diagnosing celiac disease is not easy; some patients may test positive but not show the hallmark symptoms of GI (gastrointestinal) distress. Expressed symptoms not typically linked to the disease may include chronic fatigue, depression and joint pain.

The researchers found that just 11% of individuals identified as positive for celiac disease after blood tests had ever been properly diagnosed.

Source: University of Maryland School of Medicine

Video of Dr. Fasano discussing the findings of this study

"Natural history of celiac disease autoimmunity in a USA cohort followed since 1974"

Carlo Catassi, Debby Kryszak, Bushra Bhatti, Craig Sturgeon, Kathy Helzlsouer, Sandra L. Clipp, Daniel Gelfond, Elaine Puppa, Anthony Sferruzza & Alessio Fasano

Annals of Medicine Posted online on September 27, 2010.


Celiac disease - causes, symptoms, diagnosis, treatment & pathology (Video Medical And Professional 2020).

Section Issues On Medicine: Disease