Research on a large sample of Canadians suggests that most people with celiac disease don't know they have it.
Researchers from the University of Toronto studied the bloodwork of almost 3,000 Canadians and found that one in 114 (or almost one per cent) had elevated antibodies that indicate they suffered from celiac disease. But the vast majority, almost 90 per cent, were unaware they had the disease. The data were collected about a decade ago, just before public awareness about the potential problems with gluten skyrocketed.
About celiac disease
Celiac disease is a lifelong genetically-based disorder that occurs when gluten triggers the immune system to attack and damage the lining of the small intestine, interfering with nutrient absorption.
Celiac disease can be detected by a simple blood test that measures antibodies that perceive gluten as a threat. Almost all people with celiac disease who are eating a gluten-containing diet (98 per cent) will test positive for these antibodies.
The new study is the first to screen for celiac antibodies in a Canadian population. It confirms previous research suggesting that Caucasians are more susceptible to celiac disease than other ethnocultural groups. Although the number of South and East Asians screened in the Canadian study was small, none were found to have the disease. Intriguingly, though, a genetic variant that puts people at high risk for celiac disease was almost as high in the South Asian samples as the Caucasian ones - suggesting that other factors could play a role in who goes on to develop the disease.
These findings should raise awareness that despite the gluten-free craze there are a lot of people who still don't know they have celiac disease, the researchers noted
According to a 2007 survey of the Canadian Celiac Association's more than 5,000 members, the average time it took to get diagnosed was 12 years. Many respondents had consulted three or more doctors before getting their diagnosis.
Celiac disease not one clear symptom
While stomach pain, abdominal distention and diarrhea are considered the classic symptoms of celiac disease, in adults they're often not present. Constipation and bloating may be the only outward signs.
Symptoms such as fatigue, weakness, joint pain and migraines - ones typically not recognized as gut-related - are commonly reported, and the diagnosis is often anemia, stress, irritable bowel syndrome or chronic fatigue syndrome.
Adding to the diagnostic confusion, reactions to gluten are not often immediate and acute.
The lead researcher, Dr. El-Sohemy, believes people with a genetic susceptibility to celiac disease should consider blood tests to determine whether they have the disease if they present with any of the symptoms of celiac disease.
As for why so many non-celiac sufferers feel better after giving up gluten, he speculates the real issue is "because they stopped eating heaping servings of pasta, white bread and other sources of processed carbohydrates."
Source: BMJ Open, October 2017.