Graduating medical students are sometimes told: “Half of what we have taught you is wrong…we just don’t know which half.” As amusing as this sounds, it rings true for a complex condition called celiac disease.
For decades medical students were taught that celiac disease is rare, that it affects the digestive tract and that afflicted children grow out of it. All these myths are now disproved.
Celiac disease was once thought to affect only one child in 5,000. That makes it so uncommon that few doctors would ever make the diagnosis. With such statistics, a pediatrician might see a handful of cases in a lifetime. But now researchers have found that celiac is actually quite common, affecting one person out of 100. Because genetics play a role, a person with a family member who has celiac disease has one chance in 22 of being affected.
Millions of Americans are afflicted, but most don’t even know it. It may take years or even decades for the problem to be diagnosed. By then, it could too late to undo the damage.
In celiac disease, the immune system reacts to a protein called gluten found in wheat, barley or rye. This triggers an inflammatory response in the small intestine that can interfere with efficient absorption of nutrients. Early recognition of digestive tract involvement led doctors to pay attention to symptoms such as stomachaches or diarrhea.
But many patients diagnosed with irritable bowel syndrome (IBS) may not realize their discomfort could be due to celiac disease. One study found that 12 percent of patients with IBS were gluten intolerant.
Many patients don’t have classic symptoms, however. Chronic fatigue and anemia that can’t be attributed to other causes may well be signs of celiac disease. Other immune conditions such as type-1 diabetes and thyroid disease may be associated with celiac disease. A chronic itchy rash known as dermatitis herpetiformis is another odd sign of an immune reaction to gluten.
People with gluten intolerance cannot absorb adequate amounts of calcium, magnesium, iron or other essential nutrients from food. As a result their bones become weak and brittle.
New research shows that celiac disease is common among adults with osteoporosis, affecting more than 3 in 100 (Archives Internal Med., Feb. 28, 2005). The investigators conclude that anyone diagnosed with osteoporosis should be screened for celiac disease.
Debilitating neurological disorders may also signal celiac disease. Some patients may appear to have early-onset dementia. Others experience chronic migraine or peripheral neuropathy (pain, tingling or burning in feet or hands).
For readers who would like to learn more about celiac disease, we offer a CD of a one-hour radio interview with one of the world’s leading experts on celiac disease. The show offers information on diagnosis and treatment. It is available for $15 from The People’s Pharmacy (CD- 455), P. O. Box 52027, Durham, NC 27717-2027.
Many physicians practicing medicine today never learned about the range of problems celiac disease can cause. With evidence mounting that it is common, patients deserve to be tested. For those who are affected, a strict gluten-free diet can prevent many complications.
