Would Early Screening For Celiac Disease And Gluten Intolerance Decrease The High Prevalence Of Food Allergies, Intolerances, Or Sensitivities Evident In Many Countries?
Individuals with gluten intolerance or Celiac Disease (CD) have a higher risk of food allergies, intolerances, or sensitivities due to increased bowel permeability and a maladaptive intestinal environment. Could gluten be partially responsible for the increased prevalence of allergies in many countries? Celiac Disease and Gluten Intolerance is very under diagnosed. Therefore, it could be a hidden cause. As well, the increased prevalence of allergic conditions tends to correspond with the increased prevalence of Celiac Disease. Could this be a coincidence or is there a connection?
Many suffer with food allergies, intolerances, or sensitivities. If an individual has an anaphylactic response, the effects can be devastating, if not promptly treated. Others can suffer with a wide range of multisystem symptoms that can be debilitating emotionally and physically. Could preventative screening of all children for Celiac Disease and gluten intolerance decrease the prevalence of other reactions to food? If so, I believe the costs related to this preventative screening would be well spent. Many might benefit if this truly prevented allergy development. Decreased permeability of the bowel associated with eating a strict gluten-free diet may be a preventative treatment. Healthcare dollars related to treating allergic conditions and undiagnosed CD would be saved, lives may be saved (some loose their life due to anaphylactic allergies), and many could live an increased quality of life without the stress associated with allergies and undiagnosed CD. What do you think? Do you believe there could be a connection? If you have food allergies or sensitivities, have you been tested for CD or gluten intolerance?
Extra Information: In individuals that are genetically predisposed to Celiac Disease or gluten intolerance, gluten consumption can lead to increased expression of zonulin (a human protein that is a haptoglobin 2 precursor) in the intestinal tissues. This increases intestinal permeability allowing macromolecules (ex. food antigens, bacterial, and viral particles) exposure to the immune system. The immune systems exposure to gluten and the subsequent autoimmune reaction is thought to be responsible for the intestinal and other systemic damage seen in Celiac Disease. Unfortunately, the increased bowel permeability can also increase the risk of developing food allergies/intolerances/sensitivities.
References:
1. Fasano A, Not T, Wang W, Uzzau S, Berti I, Tommasini A, Goldblum SE. Zonulin, a newly discovered modulator of intestinal permeability, and it’s expression in coeliac disease. Lancet, 2000 Apr 29;355(9214):1518-9
2. Drago S, El Asmar R, Di Pierro M, Grazia Clemente M, Tripathi A, Sapone A, Thakar M, Iacono G, Carroccio A, D’Agate C, Not T, Zampini L, Catassi C, Fasano A. Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scand J Gastroenterol. 2006 Apr;41(4):408-19.
3. University of Maryland Medical Center. Dr. Alessio Fasano MD. Researchers Find Increased Zonulin levels Among Celiac Disease Patients, Public Release 28-Apr 2000.
4.Alessio Fasano, M.D. Physiological, Pathological, and Therapeutic Implications of Zonulin-Mediated Intestinal Barrier Modulation. American Journal of Pathology, 2008;173:1243-1252.
5. Alberto Rubio-Tapia, Robert A. Kyle, Edward L. Kaplan, Dwight R. Johnson, William Page, Fredrick Erdtmann, Tricia L. Brantner, W. Ray Kim, Tara K. Phelps, Brian D. Lahr, Alan R. Zinsmeister, L. Joseph Melton, Joseph A. Murray. Increased Prevalence and Mortality in Undiagnosed Celiac Disease. Gastroenterology. Volume 137, Issue1, Pages 88-93 (July 2009).
6. Gibney MJ, Marinos E, Olle L, Dowsett J. Clinical Nutrition. Blackwell Publishing 2005.
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3 Responses to “Would Early Screening For Celiac Disease And Gluten Intolerance Decrease The High Prevalence Of Food Allergies, Intolerances, Or Sensitivities Evident In Many Countries?”
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Yes, I agree. And there are a class of molecules (lectins) that are particularly problematic for those people with increased intestinal permeability. Check out my website for more information.
Hi! Thanks for your great article. I really enjoyed it. I wanted to pass along some information to you about the Biocard Celiac Test Kit. It’s a new at-home test kit that’s already widely used in Canada and Europe and currently under review by the U.S. FDA for use in the United States. It’s a great new test that lets you test yourself at home for celiac disease through a finger prick. I’ve given the test to many of my family members since celiac is genetic and it was a quick and easy way to test them for celiac disease without causing a hassle for them.
Check it out at http://celiachometest.com/
Hi Vanessa,
Thank you so much for your comment. Yes, the celiac home test is a very convenient option. Thank you for mentioning it. With blood tests, it is important to be aware that no blood test is 100% accurate. Therefore, false negatives could occur, not only with gluten sensitive enteropathy (Celiac Disease), but also with other forms of gluten sensitivity, such as gluten ataxia. Even intestinal biopsy results can be interpreted as a false negative. As well, if someone has an IgA deficiency or no bowel involvement (like some dermatitis herpetiformis patients), then a false negative may occur since the result of this test tends to parallel the amount of intestinal damage present. Due to the elusive nature of Celiac Disease and gluten sensitivity, I recommend that individuals visit with their Medical Doctor (hopefully one that is knowledgeable about gluten sensitivity) for an overall assessment and follow-up. The doctor can test for IgA deficiency and do other tests (IgG anti-tissue transglutaminase antibody, endomysial antibody, antibodies against deamidated gluten, IgA and IgG antigliadin antibody and an upper endoscopy test) that will give a good overall picture. As well, all medical issues can be addressed and referrals can be made to other professionals, such as a Registered Dietitian, a Gastroenterologist or a Neurologist (with neurological involvement).
I do worry that individuals using the home test option may assume that they don’t have a gluten sensitivity (if the test is negative) or may not seek medical advise (if the test is positive) and proceed with putting themselves on a gluten-free diet with no follow-up (or a scope with biopsies). I hope that everyone using the home test does seek medical attention as well.
Thank you very much for mentioning the test. It is important for everyone to be aware of their options. I have talked to many who have had difficulty getting tested due their MD’s lack of awareness. This can be frustrating and can lead to unnecessary suffering in individuals who remain undiagnosed. The celiac home test provides a nice option.
Shelly
Note: Review tests mentioned in some of my posts in the 12 part series, such as the neurology post. http://celiacnurse.com/neurological-symptoms-ataxia-neuropathies-seizures-strokes-migraines-myopathies-dementia-associated-with-undiagnosed-celiac-disease-gluten-intolerance-or-sensitivities/