World wide it seems Celiac Disease is being under diagnosed. Despite its relative ease in diagnosis, involving blood tests and a gastro-scope biopsy, it is very commonly overlooked. Doctors often mistakenly believe that it is a rare disorder, even though current statistics show it at 1% of the population (this is for the US and UK; there seems to be little other data available elsewhere). This number is assumed to be even higher amongst the many undiagnosed patients. It can also be a hereditary disease and can run in families. It also is more common in people who already have other autoimmune diseases, such as Hypothyroidism, Rheumatoid Arthritis, Addison’s Disease and Type 1 Diabetes.
Another reason for it being overlooked is that there are so many overlapping disorders with common symptoms. There are people who have digestive disorder symptoms, commonly diagnosed with Irritable Bowel Syndrome (IBS), pain and fatigue, diagnosed with Fibromyalgia, with pain in their joints, diagnosed with Arthritis, yet they all might have Celiac Disease.
There are also people who have it without any symptoms besides iron deficiency anemia. People seem to commonly be treated for Arthritis or Osteoporosis or Irritable Bowel Syndrome(IBS) or Anemia and treated for these disorders without finding the root cause of the problem.
There is even the controversial idea that because it is a disease without a cure that requires medication, there is no support or funding from the Pharmaceutical industry in supporting its testing. The only treatment for Celiac is to follow a gluten free diet, and when this is done all symptoms clear up. Whereas the Pharmaceutical industry would much rather push for the anti depressants, anti inflammatories, painkillers and other medication that are used to treat the symptoms of Celiac.
Either way whatever the reason, we can no longer plead ignorance on the subject, Doctors, especially those in primary care, need to start sending patients for the tests and we need to educate the general population about it and how it is treated. It is not just some rare disorder, it is more common than people realize. The more our diets begin to rely so heavily on the white flour, highly processed, highly refined, convenience food, the more diagnoses will appear.
Celiac disease is not an allergy to gluten, like a wheat allergy is. It is in fact an autoimmune disease that is the body mistakenly attacks its own tissues seeing them as a foreign substance.
When a person with Celiac Disease eats any food containing gluten, the body reacts to those proteins found in the gluten and attacks the small finger like projections in the small intestine called villi, thus preventing absorption of nutrients.
The tests for Celiac disease involve two blood tests for anti-tissue transglutaminase antibodies (tTGA) and anti-endomysium antibodies (EMA). These are the markers for the antibodies that are produced in response to gluten in a body with celiac. If these tests are positive, then one will have to undergo a gastroscopy, in which a small tube is inserted down the mouth (you are asleep so are not aware of anything happening) and a small biopsy is taken of the lining of the small intestine to investigate whether there is damage to the villi. Even if blood tests are negative, a biopsy may still come back positive.
Then a gluten free diet will have to be maintained for life. It is dangerous to continue eating gluten, not only because of the illnesses one has, but also because left untreated, it can lead to cancer of the colon itself.
So it is vital that our primary care physicians more commonly check for Celiac Disease.