Celiac Disease Underdiagnosed in 90% of Cases?

That’s the case according to U of T prof Ahmed El-Sohemy, whose research suggests that celiac disease is very much underdiagnosed in Canada, as with other parts of the world including the US and the UK.

When he took blood samples from over 2800 people, he found that celiac disease occurs in 1% of Canadians–that’s a similar frequency to other countries in the world.

What wasn’t similar was that this frequency of occurrence did not match the frequency of diagnosis. El-Sohemy estimated that 90% of the 1% go undiagnosed.

What does that mean in numbers? For Canada, a population of 35 million people means there are approximately 350,000 people with celiac. The same 1% as most places.

But if 90% of them are undiagnosed, then 315,000 of these people don’t know they have it.

What is celiac disease?

Celiac disease is an autoimmune condition. That means your own immune system is attacking a part of your own body. In the case of celiac, when a person eats gluten, that gluten activates the immune system in their digestive system and their immune system then attacks and destroys the intestinal lining.

The result is obvious symptoms such as abdominal pain, bloating, gas, and diarrhea. But the damage to the intestinal lining also results in poor absorption of nutrients. As a result, patients with celiac can have weight loss, failure to thrive, anemia and other complaints associated with nutrient deficiencies. In fact, whenever a patient comes to StoneTree clinic with unexplained iron deficiency anemia, this is one of the first culprits we consider.

Are celiac disease and gluten intolerance the same thing?

Nope.

Celiac disease is an autoimmune disease. The gluten activates the immune system to attack the person’s intestines.

Gluten intolerance is an inflammatory response to the gluten itself–the immune system sees the gluten as the problem and attacks it, creating inflammation. Why this happens is still not totally understood.

Theories include:

  • Wheat hybrids have been bred to have more gluten and therefore more antigenic.
  • We eat too much gluten so the inflammatory reaction never has a chance to die down.
  • Wheat GMO’s (round-up ready crops) create wheat that is irritating to the immune system.

How do you test for celiac disease?

For celiac disease, the gold standard for diagnosis is an intestinal biopsy to look for tell-tale signs of damage.

This way of testing has its limitations. First, the patient needs to go to a hospital, get sedated and have a piece of their intestines removed via scope–no fun at all. Also, the patient needs to be actually eating gluten or you could go through all that trouble and get a false negative result.

Other tests for celiac include blood tests for the auto-antibody. This is easier, but also the patient also needs to be eating gluten to ensure that there is not a false negative.

Gluten intolerance can be tested by looking for an IgG antibody in the blood.

You can also test using an elimination diet. Whether you have celiac or a gluten intolerance, an elimination diet can give your own body a chance to tell you if you have a problem with gluten without relying on a test to tell you. If you have GI symptoms like symptoms such as abdominal pain, bloating, gas, diarrhea, constipation and you suspect gluten might be the culprit – just remove it from your diet for 28 days and left your body talk to you. If gluten is an issue you will know, no blood test or biopsy needed. It’s simple and cheap, but not necessarily easy!

For more information on testing, contact the clinic anytime at 705-444-5331, or book online.

Need help with gluten-free foods? Check out The pantry at StoneTree Clinic. All foods, including pre-prepared meals, are gluten- and dairy- free.

 

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