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    The Economics of Celiac Disease: Is Early Celiac Diagnosis Cost Effective?


    Destiny Stone
    Image Caption: Photo:/ CC Rob Lee

    Celiac.com 07/12/2010 - Celiac disease was at one time considered a rare disease. However, celiac is now gaining notoriety as a common genetic autoimmune disease that affects approximately 1% of Western countries. As the celiac epidemic starts to rise, the costs of medical diagnosis and treatments for celiac disease are now being scrutinized.


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    The study, approved by the Mayo Clinic and Olmsted Medical Center Institutional Review Boards, involved a group of doctors and researchers who compared population-based administrative data of celiac cases and matched controls from Olmsted County, Minnesota in an effort to evaluate: “direct medical costs 1 year pre- and post- celiac disease diagnosis for 133 index cases” and to compare 4-year cumulative direct medical costs incurred by 153 index cases against 153 controls. Total analysis excluded any diagnostic-related and outpatient pharmaceutical costs.

    The impacts of diagnostic costs for celiac disease were determined by comparing the costs accrued one year before and one year after receiving a positive celiac diagnosis. Services and costs were identified as related to the celiac diagnosis and included serological testing, endoscopy, surgical pathology and consultation and bone densitometry.

    One-hundred and fifty-three celiac patients and one-hundred and fifty-three matched controls were evaluated for medical costs that were associated with celiac disease over a four-year observation period. During that four-year period, total cumulative medical costs were observed for those patients with celiac disease.

    Following a celiac diagnosis, total direct medical costs were decreased by an average of $2,118 per year. Average costs decreased by $1,764, and over a 4-year period, celiac patients experienced higher outpatient costs and higher total costs when compared to the controls. Total excess costs were more significantly concentrated among celiac males.

    From this study, scientists were able to conclude that associated celiac disease costs indicate a profound economic burden specifically for males with celiac disease. Accurate diagnosis of celiac disease and appropriate treatments for celiac significantly reduces direct medical care costs. From this, it is evident that there is an economic advantage to early diagnosis of celiac disease.

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    Guest michelle

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    Ii found that early diagnosis would have saved 30 years of cost not to mention, false diagnosis and a long hospital stay, that almost took my life. Then one more year of suffering until Ii found out what was ailing me. Now I wait to finally get better.

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    What about the increased cost of food & time spent cooking? My life & my savings are drained. :)

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    The study doesn't even fully capture the medical costs incurred by repeatedly visiting doctor after doctor, or hospital stays, or numerous tests performed during all the YEARS before someone is finally properly diagnosed as celiac. 11 years, on average, for someone in the US to be properly diagnosed and that doesn't include all the people who haven't been properly diagnosed (so it's closer to 30 years)! And STILL it shows that there are cost savings to performing the medical tests needed to reach a proper diagnosis of "celiac".

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    Identification of Rothia Bacteria as Gluten-Degrading Natural Colonizers of the Upper Gastro-Intestinal Tract. PLoS ONE 6(9): e24455. doi:10.1371/journal.pone.0024455


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    Source:
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    Dr. Ron Hoggan, Ed.D.
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    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

    Jefferson Adams
    Celiac.com 06/14/2018 - Refractory celiac disease type II (RCDII) is a rare complication of celiac disease that has high death rates. To diagnose RCDII, doctors identify a clonal population of phenotypically aberrant intraepithelial lymphocytes (IELs). 
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    They also noted a higher frequency of surface CD3(−) IELs in cases with clonal TCR-GR, but the PCP pattern showed no associations with any clinical or pathological feature. 
    Repeat biopsy showed that the clonal or PCP pattern persisted for up to 2 years with no evidence of RCDII. The study indicates that better understanding of clonal T cell receptor gene rearrangements may help researchers improve refractory celiac diagnosis. 
    Source:
    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023