by Dr. Jeffrey Wasserman
7. October 2009 08:45
Sensitivity to wheat gluten (gliadin protein)continues to rise in the US population for unclear reasons. Celiac disease now affects at least 1% of the population, four times higher than just 50 years ago, and another 10% of the population generates some immunological response to gluten consumption. This is alarming especially when you consider that the inflammation and villous atrophy caused by the gliadin peptide has broad and lasting physiological impacts on those affected. Conditions may include malnutrition, osteoporosis (or reduced peak bone mass in adolescents), autoimmune disorders, GI disorders like IBS and neurological disorders. It should come as no surprise then that celiac disease and related GI inflammation directly increase mortality.
Last month, JAMA published the largest retrospective study comparing mortality risk in patients with a previous diagnosis of celiac disease. Data was collected from over 45,000 patients who had duodenal/jejunal biopsies across Sweden between the years of 1969 and 2008. The risk of chronic disease was higher even in patients with modest evidence of gluten sensitivity.
This report doesn't surprise those who are aware of the Celiac/gluten issue, especially concerning patients with chronic GI complaints. It should be noted that screening patients for gluten sensitivity (including genetic testing for celiac susceptibility, antibodies to gliadin, tissue transglutaminase and endomysial) is fairly straight-forward and highly recommended. The gold standard clinical approach (diagnostic and treatment) is still a gluten-free diet.
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