Risk of morbidity in contemporary celiac disease

Abstract

Celiac disease is one of the most common chronic diseases encountered in the Western world with a serological prevalence of approximately 1%. Since it is so common, much comorbidity will occur either as associations or simply by chance, or as complications of the disorder. Many of the published studies purporting to establish the frequency of these occurrences have been limited by factors such as the source and number of patients considered, choice of control groups and ascertainment bias. Recent epidemiological studies have attempted to minimize these sources of error and provide more reliable information. Autoimmune diseases constitute clinically important associations, of which Type 1 diabetes mellitus and thyroid disorders are the most important. Several liver disorders, including primary biliary cirrhosis and primary sclerosing cholangitis, are also associated. The frequency of malignant complications of celiac disease is much lower than earlier studies have indicated, with lymphoma increased by approximately fivefold and the absolute number of tumors is small. The increase in fracture risk in celiac disease is only modest. Although neurological and psychiatric conditions affect celiac patients, no disorder specifically associated with celiac disease has been identified. Reproductive problems have been overexaggerated. It is important that these co-morbidities are recognized because if not, symptoms will be falsely attributed to deliberate or inadvertent ingestion of gluten, rather than prompt a search for a second diagnosis. Furthermore, in a patient with an established diagnosis that is considered falsely to account for the whole clinical picture, celiac disease is likely to remain undetected.

Epidemiology of coeliac disease in a single centre in Southern Derbyshire 1958–2014

“…With a serological prevalence of 1% ∼524 000 individuals should be present in the UK population These results inform the structure of the coeliac iceberg particularly with regard to the ratio between diagnosed and undiagnosed patients with CD. 27 Several groups have addressed the question whether there is a relationship between the prevalence of CD and socioeconomic status but reviewed results are conflicting. 28 For example, in a study of children from South Wales, CD was more common in higher socioeconomic populations, 29 and this was confirmed in a recent large study from the UK, 28 but was not found in an investigation from Scotland.…”

Wheat Belly—An Analysis of Selected Statements and Basic Theses from the Book

“…A case-control study showed that celiac disease is not associated with an increased risk of colorectal neoplasia (53). A recent review suggests that cancer risks are lower than was once thought (54).…”

Reproductive Health Indicators Among Women with Celiac Disease in Sudan at Ibn Sina Specialized Hospital from December 2014 to June 2015

“…It is estimated to affect 1 in 100 people worldwide; 2.5 million Americans are undiagnosed and are at risk for long-term health complications [1]. Two to eight percent of patients with type 1 diabetes mellitus also have CD, and it also occurs with increased frequency in patients with Down's syndrome, Hashimoto's thyroiditis, Irritable Bowel Syndrome (IBS) and in the people with Irish, Punjabi and other South Asian ethnic backgrounds [2].…”