Celiac.com 04/23/2009 - Celiac disease is far more common among people of European descent, especially northern European descent, than among other populations. In East Asia, including China, there have been only sporadic reports of celiac disease. Historically, celiac disease has been only rarely reported in Asia.

Due to the absence of reports, and since Asian diets are traditionally low in wheat, barley or rye, it has been taken as a given that Asian populations don't really suffer from celiac disease. Still, there have been no comprehensive studies undertaken to verify this notion.

Recently, a team of Chinese researchers set out to put that assumption to the test, and to determine if celiac disease is as rare in China as presently believed.

The team was made up of L. L. Jiang, B.L. Zhang, and Y.S. Liu. of the department of Gastroenterology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.

The team performed capsule endoscopy on 62 patients with chronic diarrhea from June 2003 to March 2008. Four of those patients were clinically diagnosed with celiac disease. Endoscopy of these patients revealed classic signs of celiac disease: shortened villi of the proximal small bowel, and atrophy of the mucous membrane. Duodenal biopsy showed pathological changes of mucosa to be Marsh 3 stage celiac disease. All four patients saw significant abatement of symptoms and an improvement in their conditions when placed on gluten-free diets.

Recognizing the small sample size, the researchers hypothesize that celiac disease might be far more common in than believed in China, especially in those northern areas where wheat is the main food.

The research team points out that if celiac disease is indeed more common than thought, its diagnosis might be routinely missed, as its symptoms might be be easily covered by the symptoms from other clinical conditions, especially those subclinical patients who lack obvious symptom or those patients with extraintestinal symptoms as the first expression of the disease.

 J Zhejiang Univ Sci B. 2009 Mar;10(3):168-71.

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