Coeliac disease (CD) is an autoimmune condition where the body’s immune system attacks and damages the villi (the finger like small protrusions in the small intestine/gut). Originally considered a rare childhood condition it is now recognised as primarily an adult disease. CD is essentially a disease of malabsorption. If the cells are not getting the micronutrients from the food that we eat, then logically a number of significant health problems can eventually manifest anywhere in the body.
A recent meta analysis in The American Journal of Gastroenterology concludes that – ‘the incidence of coeliac disease is significantly rising (7.5% every year for the past few decades)’.
Incidence is the number of new cases expressed as proportion of the population being studied and provides a better understanding of what is really going on, compared to measuring prevalence, which is a measure of existing cases in a particular population.
So what is going on? A number of factors are certainly at play here including, access to improved blood tests since the 1990s; the change in guidelines in respect of being able to diagnose CD in certain children without the requirement of a biopsy and the increased awareness amongst clinicians/doctors that the classical symptoms of abdominal pain and diarrhoea occur in less than 50% of coeliacs. Other common symptoms including migraines, skin problems, depression, fertility issues, chronic fatigue, joint pain, liver and cardio vascular disease, osteoporosis, other autoimmune conditions (especially type 1 diabetes and autoimmune thyroiditis) and neurological problems. This is of course all welcome progress, but is not the full picture.
Environmental factors are also more than likely playing a significant role here. These factors include, the hybridisation of wheat to create dwarf wheat – which has a significantly higher gluten content compared to ancient varieties, the timing and amount of gluten introduced into the diet of infants, the amount of antibiotic exposure within the first year of life and the presence of childhood infections. Add into the equation the explosion in the use of glyphosate/Roundup since the early 1990s due to the practice of ‘crop desiccation’, where glyphosate (a patented antibiotic) is sprayed on wheat (and other staples) just before harvest to improve yields and one can start to understand why we are seeing the continued rise in one of the most common lifelong disorders in North America and Europe.