Twenty-two year study sees increase for celiac disease but shows a decrease in dermatitis herpetiformis
Celiac disease is an immune reaction to eating gluten, a protein found in wheat, barley and rye. If treatment is not received for celiac disease it can lead to osteomalacia or rickets in children, cancer including intestinal lymphoma and small bowel cancer, infertility, miscarriage and lactose intolerance. In the United Kingdom one in 100 people have celiac disease, with the prevalence rising to one in ten for close family members.
The National Institute of Health & Care Excellence (NICE) previously estimated that only 10 to 15 percent of those with celiac disease had been diagnosed, but according to current research by Dr. Joe West, PhD, Clinical Associate Professor and Reader in Epidemiology; Consultant Gastroenterologist, Faculty of Medicine & Health Sciences from the University of Nottingham and colleagues have found a four-fold increase in the incidence of celiac disease in the United Kingdom over 22 years.
In this new study funded by funded by Celiac UK and CORE researchers conducted a large population-based study across all regions of the United Kingdom. The team used electronic medical data between 1990 and 2011, enabling researchers to determine variations in incidence and prevalence by age, sex, geographical region, and calendar time over a 22-year period.
Researchers identified a total of 9,087incident cases of celiac disease and 809 incident cases of dermatitis herpetiformis (DH). Dermatitis herpetiform is an extremely itchy rash consisting of bumps and blisters. The rash is chronic and it occurs in conjunction with celiac disease.
Between 1990 and 2011, the incidence rate of CD increased from 5.2 per 100,000 per 100,000 person-years. However, the incident of DH decreased over the same time period from 1.8 per 100,000 to 0.8 per 100,000 person-years. The absolute incidence of CD per 100,000 person-years ranged from 22.3 in Northern Ireland to 10 in London. There were large regional variations in prevalence for CD but not DH.
In their conclusion the researchers write “We found a fourfold increase in the incidence of CD in the United Kingdom over 22 years, with large regional variations in prevalence. This contrasted with a 4% annual decrease in the incidence of DH, with minimal regional variations in prevalence. These contrasts could reflect differences in diagnosis between CD (serological diagnosis and case finding) and DH (symptomatic presentation) or the possibility that diagnosing and treating CD prevents the development of DH.”
In a news release Sarah Sleet, Chief Executive of Celiac UK commented This latest research shows that nearly a quarter of people with celiac disease have now been diagnosed and gives an up to date picture of the diagnosis levels across the UK. Of course, increasing numbers with a diagnosis is good news and will inevitably mean that there will be an increased demand for gluten-free products in supermarkets. But the three quarters undiagnosed is around 500,000 people -- a shocking statistic that needs urgent action."
The signs and symptoms of celiac disease can vary greatly. Typical signs of celiac disease are diarrhea and weight loss. Most people with celiac disease experience few or no digestive signs or symptoms. Around one-third of people diagnosed with celiac disease experience diarrhea, and about half have weight loss, 20% have constipation and 10% are obese. Other signs and symptoms of celiac disease include joint pain, headaches and fatigue, damage to dental enamel and reduced functioning of the spleen.
The only treatment for celiac disease is a gluten-free diet for life
This study appears in The American Journal of Gastroenterology.