Digestion Part 6: Celiac Disease

 

The effects of Celiac had been described for centuries, but it wasn’t until the post war period that Willem Karel Dicke identified the relationship between the symptoms and gluten. He observed that mortality rate for Celiac disease dropped from 35%-40% to zero during the second world war. After the war, the mortality rate returned to pre-war levels. During the war there was no wheat available, so flour was made with potato starch. After the war, wheat was again available and the disease returned. In the 40s and 50s Dicke did further studies to establish the link.

Celiac is an autoimmune disease, meaning it triggers the body’s natural defense mechanisms to attack healthy structures and tissue. Gluten plays a central role in this process. If the immune system believes that gluten is a threat it will create antibodies to gluten. These antibodies attack gluten, but also attack the lining of the gut. This causes inflammation of the villi which causes leaky gut and impedes their ability to absorb nutrition.

Three conditions are necessary for Celiac Disease:

  • Genetic predisposition (You must have a genetic predisposition to Celiac disease. Almost all Celiac sufferers tested so far have had at least one of either the DQ2 or DQ8 genes.)
  • Trigger (Gluten)
  • Leaky Gut (i.e. some way for the gluten to pass through the gut lining)

These three conditions were proposed by Dr. Alessio Fasano. We have known that gluten was a problem since Dicke’s research in the 40s. Recent developments in genetic science have allowed us to associate diseases with genes. The final characteristic, the “leaky gut” was unexplained. In the early 2000s Dr. Fasano discovered the protein Zonulin. Zonulin controls the cells in the gut lining and it can allow the gut to become “leaky”. (He authored a paper titled Leaky Gut and Autoimmunity – remember this is what the NHS have to say about “leaky gut syndrome”.)

 

Celiac can lead to tiredness, weakness, diarrhoea, bloating, flatulence, abdominal pain, rashes, malnourishment, weight loss, and osteoporosis. Other autoimmune diseases, like arthritis, lupus, and multiple sclerosis occur in higher rates in Celiac patients.

Screening for Celiac is not routine, it is only advised for people who have a family history of the disease, so Celiac disease often isn’t diagnosed until its effects have been identified (stomach pain and/or bloating, lack of growth in children, diarrhea, vomiting etc).

About 1% of the population have Celiac disease. However in one study, 29% of non-Celiacs were found to have gluten antibodies, meaning that the subjects were gluten-sensitive without being fully Celiac. Unfortunately, only 5% of people who actually have Celiac are ever diagnosed with it.

Worse still the prevalence of Celiac and gluten intolerance has increased significantly over the last 50 years. A 2009 study published in Gastroenterology showed that Celiac disease has increased from one in 650 people to one in 120 people over the last 50 years.

 

Now that we know what Celiac is we can discuss gluten in greater detail. You can get more info on Celiac disease at WebMD.