Tag Archives: Djokovic

How Common Is Celiac Disease?

Celiac disease, aka gluten enteropathy, affects one of every 133 Americans, according to the National Digestive Diseases Information Clearinghouse.  That’s much more common than we thought a couple decades ago.  Read about celiac disease symptoms and physical signs at About.com or the NDDIC link.

I read a few paleo diet/lifestyle blogs regularly.  In case you didn’t know, paleo diet advocates shun wheat and other grains.  Recent paleo converts often report how this or that symptom or physical condition improved when the dieter “went paleo,” often attributing the improvement to cutting out wheat products.   Wheat contains a protein—gluten—that causes disease in people who have celiac disease.  Other sources of gluten are barley and rye.

Visit WebMD for details about celiac disease: http://www.webmd.com/digestive-disorders/celiac-disease/default.htm

Click to see one definition of the paleo diet: http://paleodiet.com/definition.htm

An article in the Wall Street Journal implies that star tennis player Novak Djokovic’s recent winning streak is attributable to a gluten-free (and low-carb) diet.  Click for details: http://online.wsj.com/article/SB10001424052748703509104576327624238594818.html 

Here are Dr. Barbara Berkeley’s thoughts on Djokovic: http://refusetoregain.com/refusetoregain/2011/08/novak-djokovic-the-diet-that-conquered-tennis.html

Or is Djokovic playing so well because of the CVAC pod?: http://online.wsj.com/article/SB10001424053111904787404576532854267519860.html

If cutting out wheat from your diet improves or resolves bothersome medical symptoms, it makes me wonder if you have celiac disease.  Other possible explanations include placebo effect and coincidence.  And if you switch from a standard American diet to paleo, you’re doing more than just eliminating gluten.

I reviewed several sources for the prevalence of celiac disease in the U.S.  The best figure is one of every 133 residents. 

Most countries have a prevalence of roughly one of every 350 citizens.  Prevalence varies by country and ancestry; celiac disease is at least twice as common in whites of northern European lineage.

Full-blown classic celiac disease is relatively easy for doctors to recognize, but that’s only the tip of the iceberg.  Adults more commonly have one or two milder, nonspecific manifestations such as fatigue, malaise, depression, malnutrition (especially low iron, folate, or vitamin D), neuropathy, belly pain, headaches, thin bones, diarrhea, or a rash.  I’m glad to see increasing physician and public awareness of gluten intolerance.  If it’s not considered as a cause of these symptoms, it’ll never be diagnosed and treated appropriately.

Celiac disease is being diagnosed more often because of the availability of blood tests that help us screen for it.  If you think you have celiac disease, consider getting one of two blood tests: IgA antibodies to tissue transglutaminase, or IgA endomysial antibodies.  If that test is positive and symptoms or physical signs suggest celiac disease, the next step is usually a small bowel biopsy.

Steve Parker, M.D.

Update August 31, 2011: Tom Naughton reviewed Dr. William Davis’ new book, Wheat Belly, yesterday.  In the book, Dr. Davis notes that modern wheat varieties are vastly different from their ancient ancestors, different even than wheat of 50 years ago.  The modern varieties apparently contain much more of the gluten proteins that trigger immunologic celiac symptoms. 

Update September 13, 2011: A recent study of adult type 1 diabetics at a U.K. teaching hospital found celiac disease in three of every hundred cases.

References: WebMD.com (about one in a hundred US residents affected), University of Chicago Celiac Disease Center (one in 133 Americans affected), and MedicineNet.com (one in 3000 (sic) North Americans affected), UpToDate.com (in most countries, one in 350 have celiac disease), National Digestive Diseases Information Clearinghouse (one in 133 in U.S.).


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