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Prevalence of Celiac Disease in the Mediterranean Area


New study looks at prevalence of CD in the Mediterranean Area. Photo: Jefferson Adams

Celiac.com 05/06/2011 - Recent epidemiological studies show that the prevalence of Celiac disease had been underestimated, affecting not only Europeans, but also populations of the Mediterranean countries, such as Middle East (1-4) and North Africa (5-7), where its prevalence is similar to that of Western countries.

A international team of researchers recently set out to estimate the global burden related to undiagnosed Celiac Disease in the Mediterranean Area, as computed by morbidity, mortality and crude health cost.

The team included Luigi Greco, Laura Timpone, Carmela Arcidiaco, Abkari Abdelhak, Attard Thomas, Barada Kassem, Bilbao Josè Ramon, Boudraa Ghazalia, Cullufi Paskal, Hugot Jean Pierre, Abu-Zekry Mona, Kuloglu Zarife, Roma Eleftheria, Shamir Raanan, Ter Terzic Selma, and Zrinjka Mišak.

Prevalence of celiac disease among low risk populations varies from 0.14% to 1.17% (15-17): 1%-1.3% in Turkey (18.19), 0.6%-0.96% in Iran (20-21), 0.5% in Egypt (22), 0.6% in Tunisia and Israel (23-24), <0.5% in Jordan, Lebanon, and Kuwait (1.10,16.25). Among high risk groups (patients with positive family history, insulin dependent diabetes mellitus, thyroiditis, etc.) the prevalence of celiac disease ranges from 2.4% to 44% assessed by serological markers and biopsy (26-27).

The team discovered a celiac disease prevalence of 1%, an incidence, based on new Cases/year estimated on 1% of the live births of 1 in 7 symptomatic adults, and 1 in 5 children. Their results showed standardized mortality rate of 1.8 compared to age and sex matched population.

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They found that the delay between symptoms and diagnosis was six years for adults, and two years for children.

The team found associated conditions in 10% of the total cohort (KB 30%: Turkey 2% Iran 33% , IDDM 10% (6.7-18.5%).

Sixteen percent of symptomatic patients showed celiac disease-related complications.

The team found the following non GI Symptoms among symptomatic patients: short stature 25% Anemia 40% (20-80%) Osteopenia 30% (30-50%), abnormal liver function 10% (Turkey 38%, Iran 25%).

In the Northern Africa Region and in the Middle East very high incidence of celiac disease has recently been reported both in the general population and in at risk-group. These high frequencies are due to the wide consumption of wheat and barley and to the high frequency of the DR3-DQ2 celiac disease predisposing haplotypes in these population (13,14).

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I have 2 copies of DQ9. One from each parent.

Obviously from the outside it's difficult to comment, but if I were you I'd leave allergies for now and pursue definitive celiac testing via your doctor and preferably a gastroenterologist. They're the first port of call for digestion issues. If you do wind up being celiac it's possible that other allergies or intolerances would resolve or improve in any case once you've been on the diet for awhile. That's been my experience. Ps note that wheat allergy is completely different and unrelated to celiac or non celiac gluten sensitivity.

Thank you ps, it may be better if the thread title was changed as we now have two 'overwhelmed' topics. If it were 'Bile ducts and celiac?' then it may attract more users with direct experience?

Hello and welcome Maybe? From reading others accounts there's a big variation in how quickly gluten antibodies respond to the gluten diet. I did similar to you and my doctor said that 1 week back on should be enough to show up in a test, but he didn't know what he was talking about sadly... The 2 week figure refers to the endoscopy, for blood testing 8-12 weeks on gluten is more normal. Basically if it comes back positive fine you have your answer. If its negative it may be a false negative due to your going gluten free beforehand. If you want to pursue a diagnosis then yes. Don't go off gluten again until you confirm that all testing is complete. Keep a journal noting any symptoms, that may be useful to you later. More info here: There's some good info in the site faq: https://www.celiac.com/gluten-free/announcement/3-frequently-asked-questions-about-celiac-disease/ I know how you feel! Partway through my gluten challenge I knew that too results notwithstanding. Fwiw I think you've found your answer. Good luck!

Learn more about testing for celiac disease here: http://www.cureceliacdisease.org/screening/ You do have to be on a gluten diet for ANY of the celiac tests (blood and biopsy) to work. While the endoscopy (with biopsies) can reveal villi damage, many other things besides celiac disease can cause villi damage too: http://www.cureceliacdisease.org/faq/what-else-can-cause-damage-to-the-small-intestine-other-than-celiac-disease/ So, both the blood test and endoscopy are usually ordered. There are some exceptions, but those are not common.