Going Gluten-Free

Celiac disease and gluten-free diets grow in prevalence

/ Author:  / Reviewed by: Joseph V. Madia, MD

In recent years, the idea of a gluten-free diet has grown in popularity. As more people discuss avoiding gluten, celiac disease (which is somewhat like a severe gluten allergy) is becoming the subject of more and more research.

What are the effects of this disease and just how common is it?

Celiac Simply Put

Celiac disease is an immune disorder triggered by gluten, a protein present in foods like wheat, rye and barley.

According to an article written by Jocelyn Silvester, MD and Donald Duerksen, MD, and published in the Canadian Medical Association Journal (CMAJ), celiac disease affects the small intestine, making symptoms such as diarrhea, constipation and abdominal pain common.

Harder to identify symptoms like iron deficiency, bloating, bone and joint issues and fatigue can also be present.

Medical screening for the disease is possible and recommended if there is a family history because, as Silvester and Duerkson report, people with a close relative with celiac disease are ten times more likely than others to develop it themselves. A biopsy can be completed to confirm the condition’s presence.

According to the researchers, “because of an increasing awareness of celiac disease, people may choose to adopt a gluten-free diet before diagnostic testing,” however, they stress that testing for the disorder should be done before avoiding foods with gluten to ensure proper diagnosis.

Adopting a gluten-free diet for life is the only treatment available for the disease, say Drs. Silvester and Duerkson. Grains like millet, rice and quinoa are grains that do not contain gluten and are good options for replacements in a gluten-free diet.

As awareness of the disorder grows, the availability of gluten-free products is growing as well, making life easier for those with celiac disease.

Celiac Rates

A recent study led by the Mayo Clinic and published in the American Journal of Gastroenterology expanded upon nationwide research completed by the Centers for Disease Control and Prevention (CDC) and combined it with blood tests confirming celiac disease.

The study examined a nationally representative sample of 7,798 people over the age of six through interviews and diagnostic tests.

Of these subjects, 35 were found to have celiac disease (a rate of one in 141), with 29 of them not previously knowing of their condition.

According to the Mayo Clinic, these figures led the authors to estimate that “roughly 1.8 million Americans have celiac disease, but around 1.4 million of them are unaware that they have it.”

Interestingly, 55 subjects in the study were following a gluten-free diet, a number significantly larger than the number diagnosed. Due to this, the authors to estimate that 1.6 million Americans are following a gluten-free diet, despite not being diagnosed with the disorder.

Like Drs. Silvester and Duerkson in the CMAJ, co-author Joseph Murray, MD, also stressed the need for testing before a diet change, saying, “It is important if someone thinks they might have celiac disease that they be tested first before they go on the diet."

In this US study, the authors found much higher rates among non-Hispanic Caucasians, as 29 of the 35 who were shown to have celiac disease were non-Hispanic white.

However, the rates present in the study are similar to those found in research done in both Mexico and several European countries. This discordance between non-Hispanic rates will need to be explored further in future research.

We are sure to see more research into the presence of celiac disease as a whole and debate regarding adopting a gluten-free diet prior to diagnosis.

According to all of the researchers reviewed in this article, a diagnosis should come first, so if you suspect celiac disease, it may be wise to see your doctor for a screening before going gluten free.

As both doctors and the general public become more aware, it is likely that the availability of convenient gluten-free products will continue to grow, helping not only those with the condition, but those in their households as well. 

Reviewed by: 
Review Date: 
August 7, 2012