Celiac Disease in the United States

Celiac disease is an autoimmune digestive condition in which the body’s immune system damages the villi (fingerlike projections) of the small intestine in response to the presence of gluten, found in wheat, barley, rye, and oats. This intestinal damage prevents the absorption of key nutrients important to health, eventually leading to malnourishment in untreated individuals.

Some people with celiac disease experience symptoms, and some do not. When symptoms are present, they often resemble other digestive conditions, which is one reason celiac disease often goes undiagnosed. A recent study published in the American Journal of Gastroenterology estimated that the prevalence of celiac disease in the United States is 1 in 141 people. Most of those, not surprisingly, were found to be undiagnosed.

This estimate is thought to be the most representative of the general U.S. population because they studied 7,798 subjects enrolled in the NHANES study (National Health and Nutrition Examination Survey), an extensive survey that combines interviews and physical examinations that assess the health and nutritional status of adults and children in the United States. Celiac disease was found to be rare in minority groups and common among non-Hispanic whites, confirming the results of previous studies.

The study also reported that most people from the survey who were following a gluten-free diet (the equivalent of 1.6 million Americans) did not have a diagnosis of celiac disease, nor did they test positive for celiac by blood tests, which were used to screen for celiac disease in this study.

The researchers go on to state, “Symptomatic improvement of gastrointestinal symptoms after gluten withdrawal is considered a poor predictor of a celiac disease diagnosis. Self-treatment with a gluten-free diet is not recommended and should be discouraged.” I have to say, if symptoms improve after removal of gluten from your diet, it is a sure indication that gluten should be removed from the diet. It may not indicate that you have full-blown celiac disease, but it is likely you have gluten sensitivity, a milder reaction against gluten that leads to a whole list of health conditions.

This week, if you are suffering from digestive symptoms, or even non-digestive symptoms, and you are having difficulty getting to the bottom of it, consider that gluten may be to blame. Removing gluten from the diet—and I mean completely—for at least six weeks can give you an indication whether this is a food you should avoid for good. Underneath the fad-like appearance of the gluten-free diet is a solution to many health problems that was not previously appreciated. Give it a try.

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