New Understanding About Celiac Disease

celiacCeliac disease (CD) is an intolerance of gluten, the protein composite present in certain grains, notably wheat. It causes intestinal damage that can lead to symptoms ranging from mild discomfort to severe malnourishment. Though it was once considered rare, new data suggest that CD may, in fact, affect three million men, women and children in the United States. The disease has a genetic component, but according to Dr. Sunil K. Khurana, CEO of Premier, “not everyone with the genetic predisposition develops the disease.” He says that new research reveals a clue as to why.

It appears that infants who consume gluten in their diet during the first six months of life are more likely to develop CD than infants who breastfeed exclusively during that time. “This is not absolutely confirmed, but the message I give to new mothers is that six months of breastfeeding, without exposing the infant to foods containing gluten, reduces the risk of CD,” he says.

CD is an autoimmune disease. Triggered by the presence of gluten, an immune response damages or destroys the villi, the tiny protrusions that line the intestine and absorb nutrients from digested food into the bloodstream. Some people who do not have celiac disease, which is diagnosed through a blood test, still have sensitivity to gluten.

“These people get the symptoms of the disease—cramps, diarrhea, not feeling well—but don’t develop the metabolic problems associated with the disease, such as anemia, osteoporosis and malabsorption,” Dr. Khurana says. “We previously thought these symptoms were associated with irritable bowel syndrome, but we now know this is gluten sensitivity.”

Currently the best treatment option for both CD and gluten sensitivity involves adopting a gluten-free diet, which is both challenging and, in some cases, insufficient in relieving symptoms. Pharmaceutical companies have new medications in trial that, although they are still several years away from FDA approval, are showing promise in controlling the symptoms.

“However, these drugs are not being developed to allow patients to keep eating whatever they want,” Dr. Khurana says. “They are to help patients who, even with a strict diet, are still exposed to gluten when they eat out or use products, such as lipstick, that contain gluten,” he says. “The issue is that even if you avoid gluten, you are still exposed to it.”