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What Are the Barriers to Celiac Screening in Populations with High Celiac Rates?

Celiac.com 05/09/2014 - Even though we now have cheap, readily available celiac blood screening tests, more than eight out of every ten people with celiac disease remain undiagnosed, and the average time to in diagnosis of symptomatic individuals with celiac disease ranges from about six to eleven years.

Photo: Wiki Media Commons--Van Damme.A team of researchers recently set out to assess if patient-centered barriers have a role in stifling serologic screening for celiac disease in individuals from high-risk populations.

The research team included Erika M. Barbero, Shawna L. McNally, Michael C. Donohue, and Martin F. Kagnoff. They are variously affiliated with the Department of Medicine’s Division of Gastroenterology, and the Department of Family and Preventive Medicine’s Division of Biostatistics and Bioinformatics at the University of California San Diego in La Jolla, California, and with the Harvard Center for Population and Development Studies in Providence, Rhode Island.

The team recruited, from the general population, 119 adults at a higher risk for celiac disease. These participants answered a survey/questionnaire that addressed demographic information, celiac disease related symptoms (gastrointestinal and extra-intestinal), family history, co-morbid diseases and conditions associated with celiac disease, and patient-centered barriers to screening for celiac disease.

The team then screened all participants celiac disease using the IgA tissue transglutaminase antibody (IgA tTG), confirming positive results with an anti-endomysial antibody (IgA EMA) test.

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They found two significant barriers to serologic testing across the participant pool. The first was lack of knowledge of their higher risk level celiac disease. The second was a lack of knowledge about where and how to get tested.

They also noted that lack of access to a doctor ordered celiac screening test was a significant barrier for participants earning less than $25,000/year and those under the average participant age. This was also strongly correlated with participants lacking health insurance.

Patients with negative IgA tTG and those who tested positive showed similar symptoms and co-morbid conditions.

There are a number of major patient-centered barriers stifle celiac blood test screening. These patient-centered barrier contribute to the delayed celiac detection and diagnosis.

Education of the public and health care professionals about celiac disease symptoms, risk factors, and serologic testing can help to reduce these barriers.

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1 Response:

 
celiacMom
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said this on
14 May 2014 5:22:52 AM PDT
As always, glad you are keeping us informed of latest research.




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Yes the first has wheat gluten in the ingredients, the second via the wheat flour. Here in the UK manufacturers HAVE to highlight gluten sources. Check the ingredients and if WHEAT, BARLEY, or RYE are mentioned *usually highlighted, italicised or underlined, then you will know there's gluten. Most of iceland's processed foods will probably be gluten filled to be honest. Any breadcrumbed or battered foods for instance. Ps, you and me both have another disease, the british one of apologising You don't need to, you're very welcome here and all of your questions are valid and understandable. It's going to get better

Hi, I am deeply sorry for posting on here again. As I am scheduled for an Endoscopy on the 9th May, I wanted to make sure that my gluten intake is being kept the same. I was wondering if the ingredients to these products contain gluten even though dextrose is in one of them? http://groceries.iceland.co.uk/iceland-32-breaded-chicken-nuggets-448g/p/52275 Chicken Breast Fillet (60%), Water, Wheat Flour, Breadcrumbs (Wheat Flour, Dextrose, Salt, Yeast), Rapeseed Oil, Salt, Wheat Gluten, Sugar, Yeast Extract, Garlic Powder, Onion Powder, White Pepper, Dried Sage. http://groceries.iceland.co.uk/iceland-10-breaded-chicken-burgers-550g/p/52276 Chicken Breast Fillet (60%), Water, Wheat Flour, Breadcrumbs (Wheat Flour, Dextrose, Salt, Yeast), Rapeseed Oil, Salt, Wheat Gluten, Sugar, Yeast Extract, Garlic Powder, Onion Powder, White Pepper, Dried Sage. Thank you for all your help so far,

JMG got it down pretty much, the painful and gluten effects from eating it should clear up in a month, damage symptoms you might notice some differences as early as 2-4months but most do not noticed major improvements til about 6 months to a year. I have been gluten-free for over 3 years all my villi have healed according to the doctor on my last scope. It is very important to not cheat and avoid any kind of CC as it can set you back weeks or months. I would suggest a whole foods only diet for the first month or two, no dairy, simple stews, soups, etc. make for easy to digest and simple meals. Check out the 101 thread for some good information. PS a new combo crockpot, steamer, rice cooker combo and liners for a crock pot will be a life saver for making simple meals and easy clean ups. Quick cook microwave ware will also be handy making sure you have gluten-free cooked meals if you can not get new cookware immediately. I normally suggest cleaning out the entire house, scrubbing down knobs, handles, on the drawers, sink, fridge, cubbards etc. throw out condiment jars, checking ingredients on everything in the house including your hygiene and makeup. Putting in drawer organizers for new utensils, throwing out scratched glass, teflon, plastic, and steel cookware. Throwing out any Tupperware, and cutting boards, some utensils that can not be cleaned well. Some times you can save cast iron and stainless steel cook ware if you can run it in your ovens cleaning cycle over 600F. Gluten is a protein like blood if you can not clean a item where a CSI team will not find it give it up, it is not a germ that can be killed with disinfectant. I use freezer paper for clean prep surfaces, also makes clean up a breeze, I tend to use gloves alot also when fixing foods,

Hi Allie and welcome First off, I know 3 years was a long wait, but at 17 you've figured out celiac way before many people do. That should make a big impact on minimising its effects and helping you with the diet, so, bizarrely enough, congratulations! A lot of good advice has been brought together in this thread: Don't worry that your symptoms are bad now. As you follow the diet your body will begin healing itself and you're still very young so hopefully this will go really smoothly. Think in terms of the next 6 months rather than weeks however, recovery will likely take a little time. Eat as healthily as you can, lots of whole foods and try to avoid the gluten free processed substitutes as your digestive system needs all the help it can get at this moment. You may want to avoid dairy as well for now and think about reintroducing it later. This site has been really helpful to me and others. I hope you find it just as useful. Best of luck! ps, your increased reaction to gluten during the challenge phase was perfectly normal. Many find that reintroducing it much worse than the initial affects and take some time to get over the challenge. That's why you'll see lots of posts here urging folks to 'stay on gluten' till their testing is complete! PPS( ) Inasmuch as your post can convey emotion, your's seemed positive Stay that way! At times the diet can be a bit isolating and some friends and family may struggle to understand. I'm sure it will be difficult at times making good choices and staying vigilant when everyone around you doesn't have to think twice. Stick with it, your health is paramount and it will be worthwhile. In time your good friends will get it and those that don't aren't worth worrying about. There are great foods you can eat and if not, learn to cook them yourself

Hi! My daughter is 19 was diagnosed at age 16. It took about 12-18 month s for her to fully heal from the damage and feel "normal" again. Also because of the damage done she had reactions to dairy, so you may want to try no or minimum dairy until youre fully healed. Just a suggestion. Hope you start feeling well soon!