Celiac disease, a serious digestive disorder caused by an intolerance to gluten in the diet, is four times more common than it was in the 1950s, according to new research. And those who don't know they have the disease are a higher risk of death.
The findings come from researchers at the Mayo Clinic in Rochester, Minn. The researchers tested blood samples gathered at Warren Air Force Base in Wyoming between 1948 and 1954 and looked for an antibody that celiac patients produce in reaction to the gluten found in wheat, rye and other sources.
They then compared those results to those from two recently collected sets of blood samples from people in Olmsted County, Minn. They found that young people today are 4.5 times more likely to have celiac disease compared to young people in the 1950s.
What's more, those who were unaware they had the disease were nearly four times more likely than celiac-free subjects to have died during the study's 45-year follow-up period.
The findings are published in the journal Gastroenterology.
Dr. Joseph Murray, a Mayo Clinic gastroenterologist who led the study, said the researchers do not know why celiac disease has become more prevalent in the last 50 years.
"Something has changed in our environment to make it much more common," Murray said in a statement.
"Until recently, the standard approach to finding celiac disease has been to wait for people to complain of symptoms and to come to the doctor for investigation. This study suggests that we may need to consider looking for celiac disease in the general population, more like we do in testing for cholesterol or blood pressure."
"(Celiac disease) now affects about one in 100 people," Murray said. "We also have shown that undiagnosed or 'silent' celiac disease may have a significant impact on survival. The increasing prevalence, combined with the mortality impact, suggests celiac disease could be a significant public health issue."
In patients with celiac disease, gluten proteins trigger an immune system attack that damages the villi in the small intestine.
Villi are finger-like projections that are attached to the intestine and help it absorb nutrients. When villi are damaged, the body cannot absorb certain nutrients, which can lead to a number of other health problems, from tooth decay to anemia to premature bone loss.
Celiac is often misdiagnosed as irritable bowel syndrome or a gastric ulcer, because it shares symptoms with these conditions, such as diarrhea and abdominal pain.
There are no medications available to treat celiac disease, but patients can completely relieve their symptoms by following a gluten-free diet.
The study's findings also suggest a need for increased awareness about celiac disease among both patients and doctors.
"Some studies have suggested that for every person who has been diagnosed with celiac disease, there are likely 30 who have it but are not diagnosed," Murray said.
"And given the nearly quadrupled mortality risk for silent celiac disease we have shown in our study, getting more patients and health professionals to consider the possibility of celiac disease is important."
