Years ago, doctors thought that celiac disease was incredibly rare among Americans. In this auto-immune condition, exposure to gluten found in barley, rye and wheat causes the body to attack the lining of the digestive tract. The damage that is done interferes with the ability of the intestines to absorb nutrients properly and that can lead to serious consequences indeed. In fact, people with undiagnosed or untreated celiac disease are twice as likely to die prematurely as other individuals.

Celiac Disease Is Not Rare:

Research over the past decade has shown that celiac disease is nowhere near as uncommon as doctors once thought. It is possibly becoming more common. Certain drugs, such as antibiotics or PPI acid-suppressing medicines, may predispose susceptible people to developing celiac disease. It may take several years before people with celiac disease get a proper diagnosis; once they do, they need a gluten-free diet.

Who Might Need a Gluten-Free Diet?

Now, with gluten-free food available in most grocery stores, it is far easier to follow the prescribed diet. Should people be eating gluten-free even if they don’t have celiac disease?

For most people, it is important to see a doctor and be tested before starting a gluten-free diet. The diet could interfere with the accuracy of the test. And most people benefit from a dietitian’s advice, since gluten hides in many foods where you wouldn’t expect it.

Non-Celiac Gluten Sensitivity:

People who believe they react to gluten (but don’t have celiac disease) might have non-celiac gluten sensitivity. But many do not. It can be a challenge to follow a gluten-free eating plan that is balanced and provides adequate nutrition.

Do you really need a gluten-free diet? If so, how do you ensure that it provides all the necessary nutrients? Our guests discuss this dilemma.

A recent article in JAMA Internal Medicine (online Sept. 6, 2016) is extremely relevant to this show: “Time Trends in the Prevalence of Celiac Disease and Gluten-Free Diet in the US Population.”

This Week’s Guests:

Peter H.R. Green, MD, is the director of the Celiac Disease Center at Columbia University. He is the Ivan and Phyllis Seidenberg Professor of Medicine at the College of Physicians and Surgeons, Columbia University, and attending physician at the Columbia University Medical Center (New York-Presbyterian Hospital).

His recent research paper was on “Intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of coeliac disease.” It was published in Gut (online, July 25, 2016).

Rory Jones, MS, is a medical writer and Adjunct Professor of Narrative Medicine at Barnard College of Columbia University.

Ms. Jones and Dr. Green have co-authored two books: Celiac Disease: A Hidden Epidemic and Gluten Exposed: The Science Behind the Hype and How to Navigate to a Healthy, Symptom-Free Life.

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