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Celiac Disease Rate Increasing, Especially in the Elderly


Since 1974, the rate of celiac disease has doubled every 15 years in the United States. Back then, one in 501 people had blood markers for the disease, but by 2003, the number of people with celiac disease had increased to one in 133.

Celiac Disease is Especially Dangerous for the Elderly

Celiac disease is an autoimmune condition that causes an immune-mediated toxic reaction in individuals when they eat foods that contain gluten, a protein found in all forms of wheat (e.g., spelt, kamut, durum, semolina), as well as related grains such as rye, barley, and triticale. Individuals with this disease must eliminate all foods that contain gluten, which means reading labels carefully as gluten is found in many grocery items.

The toxic reaction triggered by gluten leads to damage of the small intestine and interferes with the proper absorption of food and nutrients, which makes the disease especially dangerous in the elderly. Symptoms of celiac disease include diarrhea and/or constipation, intestinal bloating, stomach cramps, fatty stools, and weight loss.

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In a new study, led by researchers at the University of Maryland School of Medicine Center for Celiac Research and colleagues from several other institutions, found a rising number of cases of celiac disease in the elderly. While individuals are not necessarily born with the autoimmune disease, “our findings show that some people develop celiac disease quite late in life,” noted Carlo Catassi, MD, of the Universita Politecnica delle Marche in Italy and the lead author of the paper.

Alessio Fasano, MD, director of the University of Maryland’s Mucosal Biology Research Center and the celiac research center, pointed out that even though experts have identified specific genetic markers for celiac disease, they still do not know why some people lose their tolerance to gluten. “Our study shows that environmental factors cause an individual’s immune system to lose tolerance to gluten, given the fact that genetics was not a factor in our study since we followed the same individuals over time.”

In the study, as the participants aged, the incidence of celiac disease increased. This finding was the same as that of a Finnish study which found the prevalence of celiac disease in the elderly was nearly 2.5 times higher than in the general population. Both of these studies go against a common belief that gluten intolerance develops in childhood.

The findings also suggest that if people can tolerate gluten for many years before they actually develop the disease, environmental factors as well as others must have a role in the condition, according to Dr. Fasano. If these factors can be identified, new treatments and ways to prevent the disease may be possible.

The rising prevalence of celiac disease in the elderly should prompt physicians to screen their elderly patients for the disorder, noted Dr. Catassi. At the same time, armed with this new information, researchers are trying to identify the elusive factors that are behind this autoimmune disease.

Celiac Disease Foundation
University of Maryland