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Could Less Cigarette Smoking Mean More Celiac Disease?

Celiac.com 12/07/2015 - Could population changes in smoking habits help explain the change in incidence and prevalence of celiac disease?

Photo: Jefferson AdamsCould lower rates of cigarette smoking be contributing to higher rates of celiac disease?

It is pretty well documented that cigarette smokers have lower natural rates of celiac disease than the non-smoking population, which implies that tobacco might offer some measure of prevention with regard to celiac disease.

Now, a gastroenterologist is asking whether a reduction in public smoking levels might be associated with a rise in rates of celiac disease.

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In a letter to the editors of the American Journal of Gastroenterology regarding the study "Incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades: population-based study" by West et al., Dr. S. Veldhuyzen van Zanten, MD, PhD, of the Division of Gastroenterology, University of Alberta in Edmonton, Alberta, Canada, wonders whether lower rates of cigarette smoking in the preceding decades "might help explain the study findings."

Data from several studies regarding reduced celiac rates in cigarette smokers offer support for Dr. van Zanten’s line of thinking; including data that show a new diagnosis of celiac disease is made significantly less frequently in smokers than in non-smokers.

Interestingly, there also is some evidence that cigarette smoking might actually mask the clinical manifestations of celiac disease rather than prevent its occurrence. Either way, Dr. van Zanten's hypothesis would cast some interesting light on celiac disease if proven correct.

The good news is that Dr. van Zanten’s hypothesis is easy to test. Because Canada has such a large health care database, they can easily compare rates of smoking and celiac diagnosis, and adjust for necessary factors to give a better picture of any possible connection.

Sources:

  • Am J Gastroenterol. doi: 10.1038/ajg.2014.345
  • West J , Fleming KM , Tata LJ et al. Incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades: population-based study . Am J Gastroenterol 2014 ; 109 : 757 – 68 
  • Snook JA , Dwyer L , Lee-Elliott C et al. Adult coeliac disease and cigarette smoking . Gut 1996 ; 39 : 60 – 2 .
  • Lear JT , English JSC . Adult coeliac disease, dermetitis herpetiformis and cigarette smoking. Gut 1997 ; 40 : 289 .
  • van Zanten SJOV . Case Report: Recurrent diarrhea and weight loss associated with cessation of smoking in a patient with undiagnosed celiac disease . Gut 2001 ; 49 : 588.
  • Office for National Statistics UK. Smoking prevalence among adults has declined by half since 1974. Part of General Lifestyle Survey, 2011. Released: 28 March 2013. http://www.ons.gov.uk/ons/rel/ghs/general-lifestyle-survey/2011/sty-smoking-report.html 

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3 Responses:

 
David
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said this on
16 Dec 2015 8:45:27 PM PDT
Well, I for one don't fit the model. Used to be a cigarette addict and have DH. Diagnosed at 50.

 
Loretta
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said this on
18 Dec 2015 4:38:47 PM PDT
Smoke so you don't get Celiac? Ummmm...STUPID! I smoke and I have celiac disease. I also react to all in the night shade family when eaten. Tobacco is a night shade but my stomach doesn't hurt when I smoke. I can't cure the damage to my lungs but, I can make my gut better by not ingesting gluten (actually gliadin). The fact that I smoke indeed may have masked my symptoms of celiac.

 
Jefferson
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said this on
29 Dec 2015 12:30:15 PM PDT
The article doesn't say that smokers can't get celiac disease. Neither does the doctor's letter. The doctor's letter simply notes a correlation between the decrease in the number of smokers and the rise in celiac disease, and notes several studies that point to tobacco possibly providing some protection against celiac disease, and suggests following it up to prove or disprove. He also notes your last sentence: Interestingly, there also is some evidence that cigarette smoking might actually mask the clinical manifestations of celiac disease rather than prevent its occurrence.




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So just to clarify had not consumed any gluten for about 4 days before testing. I was assured by my allergist that it wouldn't affect the test. But what was alarming was that she retested my food allergies (my most recent reaction was two weeks ago) and every food allergy I have came back negative. I don't understand how that is possible. These food allergies developed when I was 20 and I am almost 24 now.

Thanks! You too! I have learned from this experience to take charge of my own health. It's nice at least that we can try the gluten-free treatment without a firm diagnosis or a doctor confirming the disease. I've also felt some of the gluten withdrawal symptoms, and my stomach pain ebbs and flows, but I'm determined to stick with the gluten-free diet to see what a difference it makes. Gemini, thank you! This was really validating and useful for me to hear. I've felt so confused through this process and just want some answers. If the biopsy results do come back negative, I'm going to follow your advice and do the gluten-free diet with repeat blood testing after a while. If they come back positive, well, then I'll have my answer. I'm supposed to get them back next week.

I have celiac and eosinaphalic esophagitis. I was put on a steroid inhaler recently. I use it like an inhaler but swallow the air instead of breathing it in. You may want to look into EOE and it's relationship to celiac. Just a thought. My swallowing and celiac seem to be related.

You have eat gluten every single day until after testing. And the celiac blood test is supposed to be done as well.

If I was the big guy, there's no way I would have to wait 3 and a half weeks for a test lol. My GI doc never recommended the antibody test. He said doing it with the scope was the only sure way to know. Does anybody know if I should eat a little gluten the day before my test to see if I will get an accurate enough test? Or will it not matter, once the damage is done it's done?