We know that celiac disease is not the ‘rare’ disorder that I was taught it was at school. We know that at 1% incidence, it is the most common life-long disorder in the US and Europe. And we know, as of recent research, that the 1% incidence actually increases to 4 and 5% as the population ages. Therefore, we have a fairly common disorder on our hands that is poorly diagnosed.
Poor diagnosis stems partly from the fact that many doctors, such as myself, have been taught that it is a rare disorder and therefore they expect to see it in their patients only rarely. Makes sense! The other issue lies in the misunderstanding of how celiac disease presents itself. If you are ‘stuck’ in the classic model of celiac disease, you will be expecting an underweight patient, frought with diarrhea and abdominal pain. We now know that many patients, in fact the majority, don’t fit that picture. So it’s not surprising that we miss 95%+ of those suffering.
What happens for those who do get diagnosed? They are warned to follow a gluten free diet and sent on their way. Research now shows that many patients are not diligent following their gluten-free diet and tend to cheat.
A recent journal article in Gastroenterology & Hepatology entitled “Emerging Therapeutic Options for Celiac Disease: Potential Alternatives to a Gluten-Free Diet”, reviewed the latest advancements being made to make having celiac disease less of a burden.
The researchers hailed from the George Washington University Medical Center. Their goal was to isolate the most recent advancements that are occurring to ease the burden of maintaining a gluten-free diet as we know it today. While none of these therapies are available right now, the sheer number of them being worked on makes us hopeful that they will soon come to fruition.
The researchers correctly stated that the three main pathways causing celiac disease (and gluten sensitivity, I may add) are:
- The presence of the environmental trigger gluten
- Genetic susceptibility
- Increased gut permeability (leaky gut)
The new treatments on the horizon include:
- Engineering gluten-free grains – I’m not sure what the taste would be, but the concept is interesting.
- Decreasing intestinal permeability [leaky gut] by blocking zonulin receptors – zonulin is what makes the gates of the small intestine open and close
- Inducing oral tolerance to gluten with a vaccine – the body’s immune system would then stop reacting to the protein gluten.
- Degrading gluten proteins using probiotics and enzymes or enzyme inhibitors – this is a ‘pre-digestion’, if you will, that will prevent the negative reaction of the immune system from occurring.
What is exciting about all the above is that they are non-diet therapies. You could ‘eat what you want,’ supposedly, and fear no negative consequences.
It may seem a bit unfair to discuss these when they don’t yet exist, but I think it’s important for you to know where research is headed. Dr Fasano from the University of Maryland’s Celiac Research Center received a very large personal endowment for his continued research. Maybe you know someone who could assist in bringing one of these treatments to fruition sooner.
Miracles happen! In the meantime we need to be perfect on our gluten-free diets and encourage those we know to get tested and educated. Stay strong and hopefully, for those who have difficulties following the diet, life will get a bit easier soon.
I hope you found this helpful. Please let me know if you have any questions or if you know someone who needs a free health analysis. Our destination clinic treats patients from across the country and internationally. We are here to help!
To your good health,
Dr Vikki Petersen, DC, CCN
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”
Author of the e-Book: “Gluten Intolerance – What you don’t know may be killing you!”
Gastroenterol Hepatol (N Y). 2012 Sep;8(9):582-588. Emerging Therapeutic Options for Celiac Disease: Potential Alternatives to a Gluten-Free Diet.