CeliacNet: Celiac Primer

About Celiac Disease

Celiac disease (CD), also known as celiac sprue and gluten-sensitive enteropathy, is the inability of some individuals to digest the gluten found in wheat, rye, and barley. To a celiac, these cerelas are toxic and destroy the villi in the small intestine. This prevents the digestion of not only gluten, but also other nutrients.

Due to this toxicity, celiacs must maintain a gluten-free diet, which forbids the consumption of any of these grains. In addition, oats are often contaminated by gluten-containing grains and therefore, all oats that aren't pure must be excluded from the gluten-free diet.

Celiac disease is a genetic-based autoimmune condition that seems t present only in people who present the HLA DQ2 or DQ8 genes. However, these genes are present in a third of the world's Caucasian population, and in varying amounts in other ethnic groups. A trigger of some sort is required to actually cause the disease. It is this trigger that many researchers are now working to determine. Approximately 90-95% of celiacs are DQ2-positive and 5-8% of celiacs are DQ8-positive.

According to the University of Chicago Celiac Disease Program, there are 2.2 million people in the United States (1 in 133) living with CD, 97% of which are undiagnosed. To put it in perspective, there are only 2.1 million Americans with rheumatoid arthritis. And yet doctors are still being taught that celiac disease is a rare condition and not to look for it. It takes an average of eleven years for a symptomatic celiac to be dianosed, and it usually takes visits to six doctors. While the prevalence in healthy Americans is 1 in 133, it increases to 1 in 56 in people with related symptoms, 1 in 22 in people who have a first-degree relative with CD, and 1 in 39 in people with second-degree relatives with CD. The rate is higher in Caucasians, but it's still 1 in 236 in African-, Hispanic-, and Asian-Americans.

Newer testing procedures that paired standard blood tests with genetic tests in the hope of eliminating false positives indicated that, at least in the population tested (2500 people from Victoria, Australia), celiac disease may be more common than previously thought. The study, reported here and here, indicates at least 1 in 60 women and 1 in 80 men may be affected, not 1 in 100 as previously thought.

Next: Symptoms of Celiac Disease