Mayo Clinic study proves celiac disease is on the rise--Could you be gluten-intolerant?

Celiac disease, in which wheat and other gluten-containing grains are not tolerated, is a growing problem in the U.S and around the globe. Researchers at the Mayo Clinic published a study in July, 2009 showing the disease is now four times more common than it was 50 years ago.

The study was specifically designed to determine if the increase in incidence is real, or rather the mere result greater awareness of the disease and better ways of diagnosing it. The study clearly shows that the increased incidence is real--the percentage of people suffering from celiac disease has definitely increased.

The same study, published in the journal Gastroenterology, also found that those who have this common disease have a four-fold increased risk of earlier death if they fail to undergo proper diagnosis and treatment. Unfortunately, the disease is often missed and wildly under-diagnosed.

Celiac expert Stefano Guandalini, MD, Director at the University of Chicago Celiac Disease Center, recently discussed the problem of under-diagnosis in a WebMD article titled “Celiac Disease Cases Are on the Rise“. “We believe only about 5% of people with celiac disease know they have it,” he said. “Many of these people have no symptoms, but many do have symptoms that are just not recognized for what they are.”

Other studies have indicated that an estimated one in 100 people have celiac disease, although most remain undiagnosed.

In the current study, Mayo Clinic researchers analyzed blood samples that had been collected and stored from 9,133 healthy male army recruits between 1948 and 1954. The samples were tested for the presence of celiac-specific antibodies known as tissue transglutaminase and endomysial antibodies.

Also analyzed were recently collected blood samples from 12,768 men that were either born around the same time as the recruits or were a similar age when the blood samples were taken.

While a biopsy of the intestinal lining remains the gold standard for diagnosing celiac disease, recent studies have shown that blood testing alone is adequate for diagnosing the disease in the many patients who do not have the classic “high risk” symptoms of diarrhea, anemia, or weight loss.

Based on the blood test results, only 0.2 percent of the group from 50 years ago had celiac disease, while the incidence of celiac disease was more than four times greater in the more recent study group.

Reasons for the increased incidence of celiac disease remain unknown. Experts mention a number of hypothetical causes. Joseph A. Murray, MD, lead author of the Mayo study, discussed the hypothetical causes on WebMD. "Celiac disease is unusual, but it's no longer rare," he says. "Something has changed in our environment to make it much more common."

According to WebMD, lead author Murray believes that the rise in celiac disease may be due to changes in the way wheat is grown and processed. He also considers the “Hygiene Hypothesis”, which theorizes that increases in celiac disease, along with other autoimmune diseases, asthma, and allergies, may be in part caused by modern-day reductions in exposures to germs and infections at an early age.

For now, the true cause of the rise in celiac disease incidence remains unknown. Fortunately, awareness is increasing, as is the availability of gluten-free foods, celiac-specific information, and support.