coeliac disease

Home Wellbeing Health Is it coeliac disease? New campaign aims to raise awareness of anaemia and undiagnosed coeliac diease

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A new campaign by the charity Coeliac UK launched today aims to focus attention on the link between anaemia and undiagnosed coeliac disease, to mark the start of Coeliac UK Awareness Week.

  A new campaign by the charity Coeliac UK launched today aims to focus attention on the link between anaemia and undiagnosed coeliac disease, to mark the start of Coeliac UK Awareness Week.

One in 100 people in the UK has coeliac disease, while, current research indicates that only 24% of those with the condition are diagnosed, leaving an estimated half a million people in the UK struggling with undiagnosed coeliac disease5. Undiagnosed coeliac disease can lead to a number of complications including osteoporosis, fertility problems and, in rare cases, small bowel cancer if left untreated.

Almost a quarter (23%) of British adults recalled being told they were anaemic following a blood test, according to a recent YouGov survey¹ for Coeliac UK; the charity is concerned that as anaemia is experienced in up to 50% of patients with coeliac disease at diagnosis, many with anaemia may have undiagnosed coeliac disease.

Iron-deficiency anaemia is experienced by 2-5% of men and postmenopausal women and 5-12% of premenopausal women in the UK at any time², but occurs in some 30-50% of patients with coeliac disease at diagnosis³. NICE Guidance for the recognition, assessment and management of coeliac disease recommends that GPs screen patients with recurring or unexplained iron, B12 or folate deficiency anaemia for coeliac disease4.

One in 100 people in the UK has coeliac disease, while, current research indicates that only 24% of those with the condition are diagnosed, leaving an estimated half a million people in the UK struggling with undiagnosed coeliac disease5. Undiagnosed coeliac disease can lead to a number of complications including osteoporosis, fertility problemsand, in rare cases, small bowel cancer if left untreated.

Almost a quarter (23%) of British adults recalled being told they were anaemic following a blood test, according to a recent YouGov survey¹ for Coeliac UK; the charity is concerned that as anaemia is experienced in up to 50% of patients with coeliac disease at diagnosis, many with anaemia may have undiagnosed coeliac disease.

Iron-deficiency anaemia is experienced by 2-5% of men and postmenopausal women and 5-12% of premenopausal women in the UK at any time², but occurs in some 30-50% of patients with coeliac disease at diagnosis³. NICE Guidance for the recognition, assessment and management of coeliac disease recommends that GPs screen patients with recurring or unexplained iron, B12 or folate deficiency anaemia for coeliac disease4.

Sarah Sleet, chief executive of Coeliac UK the national charity for people with coeliac disease said: “Recurring or unexplained anaemia, is a key symptom to help in the search for those with undiagnosed coeliac disease. These people are probably suffering in silence, taking supplements and worrying about what’s causing their anaemia off and on for years, when a simple blood test for coeliac disease might just reveal the answer and change their life for the better, forever.”

The charity recommends those wondering if they need to be tested for coeliac disease to take its online assessment, which allows people to check symptoms and related conditions and advises whether they should go to their GP to be screened. Since the assessment was launched under a year ago, over 30,000 people have taken the questionnaire. From feedback, the initial results suggest that around 8% of those who were recommended to seek testing went on to be diagnosed with coeliac disease.

Simpler diagnosis of coeliac disease: Australian scientists devise new test

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Blood test will do away with the need for people to eat gluten for weeks before a diagnosis can be made, says lead researcher

Tye-Din
Jason Tye-Din, Cathy Pizzey, Adam Girardin and Melinda Hardy (left to right) are developing a new blood test to diagnose coeliac disease. Photograph: Walter and Eliza Hall Institute website

Australian scientists have made progress towards a blood test that could dramatically simplify the diagnosis of coeliac disease.

The test will do away with the need for people to eat gluten for weeks before a diagnosis can be made, says lead researcher Dr Jason Tye-Din, head of coeliac research at the Walter and Eliza Hall Institute in Melbourne.

Results will take 24 hours and people will not need to have tissue samples taken from their intestines.

A pilot study on 48 people shows the test is accurate after only three days of gluten consumption, says Tye-Din.

Many people follow gluten-free diets without a formal diagnosis and the current testing method requires them to eat gluten again, which is often unpleasant and difficult, says Tye-Din, a gastroenterologist at Royal Melbourne hospital.

It will, however, be several years before the new test is available for general use, he says.

Coeliac disease is caused by an abnormal immune reaction to gluten in the diet, leading to damage to the small intestine.

It can cause digestive symptoms such as nausea, vomiting, bloating, and diarrhoea, as well as lethargy, anaemia, headaches and weight loss.

Long-term complications include malnutrition, osteoporosis, pregnancy issues and liver failure.

Up to one in 60 women and one in 80 men in Australia have the condition, but most are undiagnosed.

Tye-Din, whose study is published in the journal Clinical & Experimental Immunology, believes a simple test will greatly improve diagnosis and treatment.

The study is supported by by Coeliac Australia, the Australian National Health and Medical Research Council and the Victorian government.

10 Symptoms of Gluten Intolerance.

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More than 55 diseases have been linked to gluten, the protein found in wheat, rye, and barley. It’s estimated that 99% of the people who have either gluten intolerance or celiac disease are never diagnosed. It is also estimated that as much as 15% of the US population is gluten intolerant. Could you be one of them? If you have any of the following symptoms it could be a sign that you have gluten intolerance:


1.) Digestive issues such as gas, bloating, diarrhea and even constipation. I see the constipation particularly in children after eating gluten.

2.) Keratosis Pilaris, (also known as ‘chicken skin’ on the back of your arms). This tends be as a result of a fatty acid deficiency and vitamin A deficiency secondary to fat-malabsorption caused by gluten damaging the gut.

3.) Fatigue, brain fog or feeling tired after eating a meal that contains gluten.

4.) Diagnosis of an autoimmune disease such as Hashimoto’s thyroiditis, Rheumatoid arthritis, Ulcerative colitis, Lupus, Psoriasis, Scleroderma or Multiple sclerosis.

5.) Neurologic symptoms such as dizziness or feeling of being off balance.

6.) Hormone imbalances such as PMS, PCOS or unexplained infertility.

7.) Migraine headaches.

8.) Diagnosis of chronic fatigue or fibromyalgia. These diagnoses simply indicate your conventional doctor cannot pin point the cause of your fatigue or pain.

9.) Inflammation, swelling or pain in your joints such as fingers, knees or hips.

10.) Mood issues such as anxiety, depression, mood swings and ADD.

Source: Eat Local Grown

Why Take Follow-Up Biopsies in Celiac Disease?

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Results provide status of mucosal healing, which is associated with risk for lymphoma.
Celiac disease is a risk factor for T-cell lymphomas of the intestine as well as a variety of other malignancies. Some experts believe that adherence to a gluten-free diet mitigates this risk. Guidelines suggest repeating serologic testing after several months on a gluten-free diet, but follow-up biopsy sampling to confirm healing is not routinely performed. Now, researchers consider its value for assessing cancer risk.

To examine the association between mucosal healing in celiac disease and the risk for lymphoproliferative malignancy (LPM), investigators in Sweden conducted a retrospective, population-based cohort study of 7625 patients with celiac disease who had at least one follow-up biopsy taken after diagnosis. Biopsies were taken at least 6 months after initiation of a gluten-free diet and at a median of 1.3 years after diagnosis. LPM occurrence was determined using a nationwide cancer registry.

In multivariate analysis, patients with persistent villous atrophy on follow-up biopsy had a higher risk for LPM compared with the general population (standardized incidence ratio, 3.78; 95% confidence interval, 2.71–5.12) and compared with patients with mucosal healing (hazard ratio, 2.26; 95% CI, 1.18–4.34). The risk estimate was highest for T-cell lymphoma, though not statistically significant. Total or subtotal villous atrophy was more strongly associated with T-cell lymphoma (HR, 9.23) than partial or no villous atrophy (HR, 3.4).

COMMENT

This study confirms the increased risk for lymphoproliferative malignancy in patients with celiac disease. Further, it documents for the first time that the risk for LPM, particularly T-cell lymphoma, is predicted by the degree of mucosal healing on follow-up biopsy. These findings strongly suggest that, as in inflammatory bowel disease, mucosal healing is an important therapeutic goal. Follow-up biopsy at 6 to 12 months after initiation of a gluten-free diet should be considered, with the goal of achieving resolution of villous atrophy.

Source: NEJM

Increased risk of end-stage renal disease in individuals with coeliac disease.

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The prevalence of end-stage renal disease (ESRD) is increasing worldwide. Although increased levels of coeliac disease (CD) autoantibodies are often seen in renal disease, the importance of biopsy-verified CD for the risk of future ESRD is unclear. The aim of this study was therefore to investigate the risk of future ESRD in individuals with CD.
METHODS: This was a population-based prospective cohort study. 29,050 individuals with CD (Marsh III) were identified through small-intestinal biopsy reports obtained between July 1969 and February 2008 in Sweden`s 28 pathology departments. ESRD was defined as the need for renal dialysis or renal transplant in accordance with the international classification of disease and procedure codes in Swedish patient registers. Using Cox regression, the risk of ESRD in individuals with CD compared with age- and sex-matched reference individuals was estimated.
RESULTS: During follow-up, 90 individuals with CD developed ESRD (expected count 31). This corresponded to a HR for ESRD of 2.87 (95% CI 2.22 to 3.71, p<0.001). Adjusting for diabetes mellitus had only a marginal effect on the risk estimate (HR 2.52, 95% CI 1.92 to 3.31). Excluding individuals with any urinary/renal disorder before study entry, the HR for ESRD in CD was 2.47 (95% CI 1.80 to 3.40). When restricting the outcome measure to ESRD confirmed by independent data from the Swedish Renal Registry (SRR), the risk estimate increased to 3.20 (95% CI 2.39 to 4.28).
CONCLUSION: This study indicates that individuals with biopsy-verified CD suffer increased risk of subsequent ESRD.

Source:Gut