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Is Celiac Disease More Common Than We Think?

As healthcare researchers refine their approach to diagnosing celiac disease, they are finding that the immune disorder may be more common than previously thought.

How Celiac Disease Is Diagnosed

Nowadays, if a doctor thinks someone may have celiac disease, he or she runs blood work to see if the body has produced antibodies to fight against gluten—a protein found in wheat, rye, barley, and related grains.

If the blood work comes back positive, the doctor schedules a biopsy of the small intestine to see if it has been damaged. Only then can a diagnosis of celiac disease be made.

A biopsy is an invasive and costly procedure, and sometimes people get false positives, so researchers have been working on a way to improve the process.

Celiac Test for the Future?

Australian researchers recently tested a new approach to detecting celiac disease—combining traditional antibody testing with an assessment of specific genetic risk markers—before moving on to a biopsy.

They found that more than half of people who tested positive for celiac disease also shared certain genetic risk factors. The combination of using antibody tests with a genetic test should increase the accuracy of diagnosis. Meaning, more people who go in for a biopsy will actually have celiac disease.

The development of a new way to test for the disease could decrease medical costs and also avoid a potentially unnecessary adoption of a 100 percent gluten-free diet.

Celiac Disease Underreported?

The new testing strategy also uncovered that the disease might affect at least 1 in 60 Australian women and 1 in 80 men. The findings indicate that the current accepted prevalence of the disease in the United States—1 in 133—may need to be reevaluated.

One of the researchers, Dr. Jason Tye-Din from the Walter and Eliza hall Institute, who also leads the Celiac Clinic at the Royal Melbourne Hospital, said the findings were surprising. “It is concerning that a significant number of people in the community with celiac disease have not been diagnosed.”

SELECTED SOURCES

“A Novel Sero-Genetic Approach Determines the Community Prevalence of Celiac Disease . . .” by R. P. Anderson et al., BMC Medicine, 2013

“New Approach to Celiac Testing Identifies More at Risk,” www.sciencedaily.com, 8/27/13

 

 

Celiac Detective Work

Computers are now being enlisted to do a bit of the detective work involved in diagnosing celiac disease.

Researchers in Sweden have found that by using certain search terms in computerized algorithms of electronic medical records, they were able to identify patients at high risk of celiac disease in need of screening.

“Use of Computerized Algorithm to Identify Individuals in Need of Testing for Celiac Disease” by J. F. Ludvigsson et al., J Am Med Inform Assoc, 8/16/13

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