Serology-based prevalence studies report that between 1 and 2 percent of the global population has celiac disease, though many of these cases remain undiagnosed. Distribution is fairly equitable across the continents, with marginally higher prevalences in Europe and Asia.
The disease tends to affect women more often than men and children more often than adults. According to the Celiac Disease Foundation, rates have been increasing by about 7.5 percent per year for several decades.
“The increase in celiac disease is partially due to the increase in awareness and testing, but there has also been a true increase in the prevalence over time,” says Alessio Fasano, MD, director of the Center for Celiac Research and Treatment at Massachusetts General Hospital and author of Gluten Freedom. “The incidence is doubling every 15 years.”
What’s behind this rise?
“We don’t know, but it’s likely because we’re derailing from evolution’s plan in terms of having friendly interactions with the ecosystem — the soil, air, and water,” Fasano explains. “Chemical pollution and other factors impinge on our gut microbiome, which determines if, when, and why our genes are put into motion.”
“Chemical pollution and other factors impinge on our gut microbiome, which determines if, when, and why our genes are put into motion.”
Celiac does have a genetic component, but not everyone with the genes for it develops the condition. Up to 30 percent of us carry a gene that puts us at greater risk, though it only increases the risk from 1 percent (the risk for the general population) to 3 percent. The likelihood of developing celiac does go up substantially for those who have a parent, sibling, or child with the disease.
Onset can occur during childhood or adulthood. Children are more likely to have digestive symptoms, such as abdominal bloating and pain, diarrhea, constipation, or nausea. Adults with celiac may also display these symptoms or others, such as fatigue, brain fog, headaches, depression, anxiety, skin rashes, or joint pain. Some, like Wethern, don’t notice any symptoms at all.
People with celiac disease produce antibodies called anti-tissue transglutaminase antibodies. “Transglutaminases are enzymes that help bind proteins together and are also involved in the digestion of wheat in the gut,” explains functional-medicine practitioner and clinical researcher Datis Kharrazian, PhD, DC, MS, FACN, author of Why Isn’t My Brain Working?.
In people with celiac, gluten triggers immune reactivity to the type of this enzyme that’s located in the intestinal lining. For this reason, gluten must be strictly avoided for the rest of the person’s life or symptoms will recur.
This was excerpted from “A Guide to Understanding Gluten and Gluten Sensitivity” which was published in Experience Life.
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