Why Is Celiac Disease Profile Changing Rapidly?
Majid Ali, M.D.
Proliferation of humankind and spread all over the globe was primarily fueled by wheat energy. Who would have imagined that wheat would be demonized as a killer grain in twentieth century? How did it come to pass that every self-respecting grocery store would stock shelf after shelf with gluten-free foods? The answer: In the United States, we own and pride in our diseases. We fiercely fight to protect our right to own our diseases – more than the gun lobby fights to protect the right to own guns. We must always have a disease of the decade or two. And these are the decades of gluten diseases. No self-respecting American can tolerate opposition to celiac disease and gluten sensitivity.
Until fifty years ago, the terms celiac disease and gluten sensitivity were known only to doctors. In 1960, in my third year at King Edward Medical College, Lahore, Pakistan, I considered these entities to be learned and remembered until I passed the examination in my pediatric course. I desired to be a surgeon and I did not think surgeons then were interested in such gut problems. In 1968, I arrived in the United States and saw little reason to ever open my textbooks to look for celiac disease and gluten sensitivity.
Celiac disease (sprue by another name) is an immune-inflammatory entity. It is believed to be caused by a family of gluten proteins in wheat, oat, barley, rye, and in smaller amounts in other grains. True celiac disease accounts for a relatively smapp number of individuals clinically diagnosed to have gluten sensitivity. It occurs in genetically predisposed people of all ages from middle infancy onward. Symptoms include pain and discomfort in the digestive tract, chronic constipation and diarrhea, failure to thrive (in children), anemia and fatigue, but these may be absent, and symptoms in other organ systems have been described. Vitamin deficiencies are often noted in people with celiac disease owing to the reduced ability of the small intestine to properly absorb nutrients from food.
How Did Celiac Disease Become a Darling of Disease-lovers?
Before I answer this question, let us consider the findings of a landmark study conducted by Italian researchers and published in the journal BMC Gastroenterology on November 18, 2014. The three graphs reproduced below from that study tell the story of how celiac disease has changed.