This post is fourth in a series. You can read the first three posts here:
There are approximately 110,000 people in the U.S. diagnosed with celiac disease. According the the prevalence study done by the Center for Celiac Research, there are 3 million people who actually have the disease. The incidence of celiac disease is also increasing over time and seems to double every 17 years (along with other autoimmune diseases).
Screening everyone for celiac is not cost effective, but screening symptomatic people is. As many of you know, going for years without diagnosis is costly both financially and in the price your body pays. Early detection saves money and is better for everyone.
Point of Care Test – This pregnancy type test for celiac disease is available in Canada. Dr. Fasano does not see it as being a good alternative for diagnosis for the average person. He sees its uses as being limited to needing a diagnosis in the middle of nowhere, or for someone already diagnosed to see if they might be getting cross contamination somewhere.
Diagnostic algorithms – These could be used in the future to avoid biopsy.
Prevention – A study on children (with a first degree relative with celiac) is in the early stages to determine if introducing gluten into a diet later (12 months rather than 6 months of age) allows the immune system to develop more fully and prevent the development of celiac disease.
Drug treatments – There are a number of clinical trials going on in different parts of the world. Each addresses the problem at a different stage in the process. The gluten free diet address stage zero. If you don’t let gluten enter the body, the other steps cannot take place. This is still the best treatment for celiac disease. Other treatments being tested include a vaccine, and enzymes found in bacteria which would break down gluten so it was not seen as a problem. Gluten is a protein that is not completely digested by anyone.
The drug being tested by Alba Therapeutics here in the U.S. (I took part in the trial in 2006) is aimed at fixing the problem of leaky gut. They are in phase III of the trials, so the drug has come a long way in the process of being approved, but at this stage, only 2 or 3 out of 20 drugs are actually approved.
If approved, it is a drug that would be taken before eating. Dr. Fasano sees its uses as being limited to: a) people such as teenagers who will not comply with the diet, b) being used as a safety net when eating in somewhat risky situations c) being used for an occasional piece of birthday cake. He would not recommend it to be used in place of the gluten free diet.
Dr. Fasano encouraged us more than once to not complain. In the spectrum of autoimmune diseases, celiac disease is the one to have. Because the environmental trigger is known, we have an effective, drug-free treatment in the form of the gluten-free diet. Let’s all take heed and be thankful.
This is the last post in this series. For more information as well as detailed pictures, read Dr. Fasano’s article in Scientific American entitled “Surprises from Celiac Disease.”