Celiac disease is MORE common than thought

Celiac disease (sprue) is more common than previously thought. Celiac disease is now believed to affect one of every 120 to 300 persons in North America (it affects up to 1% of Americans), but many are undiagnosed or misdiagnosed. It's often mistaken for irritable bowel syndrome...

     Patients with this autoimmune disorder make antibodies to the gluten proteins that are in wheat, rye, and barley. These antibodies destroy the villi in the small intestine and lead to malabsorption, diarrhea and weight loss.

Note;

The following is a list of associated conditions that could indicate the need to consider celiac disease: Failure to thrive, unexplained short stature, Down syndrome, chronic fatigue, type 1 diabetes, GI complaints (e.g., diarrhea, constipation, abdominal pain, dyspepsia, esophageal reflux), osteopenia/osteoporosis, hypocalcemia, secondary hyperparathyroidism, neurological problems (e.g., ataxia, peripheral neuropathy, epilepsy), anemia (e.g., iron, folate, or vitamin B12 deficiency), dermatitis herpetiformis, aphthous stomatitis, dental enamel defects, gynecologic problems (e.g., delayed menarche, premature menopause, infertility, spontaneous abortion), liver disease (e.g., primary biliary cirrhosis, autoimmune hepatitis, elevated transaminases), thyroiditis, and Sjogren's syndrome.

Celiac patients are at risk for vitamin and mineral deficiencies, anemia, osteoporosis, etc. These patients may require supplemental replacement of iron, folate, vitamin B12, calcium and vitamin D, etc. They need to avoid gluten in foods AND drugs. Even the small amounts of gluten in drugs can be a problem. Some drugs use excipients that contain gluten. Tell patients to watch for labels that say wheat starch, flour or dusting powder.

Explain that dextrins, malt and caramel coloring can also contain gluten, depending on the source. But drugs and foods made from rice, soybean, and corn are okay. Advise celiac patients to contact the manufacturer or ask their pharmacists to check if medications are gluten-free. Gluten content can change from lot to lot, depending on the supplier of the raw material.

REFERENCES

• NIH Consensus Development Conference on Celiac Disease. NIH Consens State Sci Statements. 2004 Jun 28-30;21(1):1-23. Available at: https://pubmed.ncbi.nlm.nih.gov/17308551

  Fasano A. Celiac disease--how to handle a clinical chameleon. N Engl J Med. 2003 Jun 19;348(25):2568-70. Available at: https://www.nejm.org/doi/full/10.1056/NEJMe030050

  Crowe JP, Falini NP. Gluten in pharmaceutical products. Am J Health Syst Pharm. 2001 Mar 1;58(5):396-401. Available at: https://pubmed.ncbi.nlm.nih.gov/11258175