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Age and Celiac Disease -- Going Against the Grain?

*GG*

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Its a good thing that age brings wisdom, because it brings lots of other less desirable changes, too. One of the more surprising ones Ive heard about lately is an increased susceptibility to celiac disease (or gluten intolerance). According to Joseph Murray, MD, a Mayo Clinic gastroenterologist, it was once unusual for a new case of celiac disease to be diagnosed in an older man or woman, but thats no longer the case. "Now its as common as in younger people, and were making diagnoses in 70- and even 80-year-olds," he said. This means that seniors should be alert to the possibility that while new digestive difficulties that seem to develop as they get older could be the result of age, they also could be celiac disease.

Celiac disease is a tough diagnosis to pin down, Dr. Murray acknowledged, so it is possible that at least some of those older folks have gone undiagnosed for years. But he emphasized that incidence of the disease is unquestionably rising dramatically, most particularly among older people who are now known to be twice as likely as the general population to develop celiac disease.

Why Is This Happening?

Genetics definitely play a role in susceptibility to celiac disease (as with all autoimmune diseases -- see Daily Health News, October 28, 2010, "When Your Immune System Fights Itself," for more on this topic), but Dr. Murray and others believe that environmental factors are contributing to the problem. Looking for antibodies that accompany celiac disease, he and his team analyzed three sets of blood samples -- blood (taken for other reasons) from Air Force recruits that was drawn 50 years earlier and stored in a lab freezer... blood taken recently from young men whose ages matched those of the airmen at the time that their blood had been drawn... and new blood samples taken from elderly men who are contemporaries of the now elderly Air Force recruits. Using modern testing methods, the researchers found evidence of undiagnosed celiac disease in some of those old frozen blood samples.

Their comparisons of the groups showed that the elderly men today have four times the incidence of celiac disease compared with the young recruits of 50 years ago and that the disease is 4.5 times more common among todays young men than the young men of the 1950s. Also, in investigating the health records of the 1950s recruits, Dr. Murray learned that the ones whod had undiagnosed celiac disease were four times more likely than the other recruits to have died since then

"These results tell us that whatever happened to increase celiac disease happened after 1950," says Dr. Murray -- hence the theory that some change in the environment is responsible. Two possibilities: Dr. Murray said one reason might be that our "clean" lifestyles have so dramatically reduced the number of germs in our environment that our immune systems have been left with too little to do, so theyve turned against us... or that changes in how much wheat we eat as well as how wheat is grown and processed may be partially or fully to blame.

Should You Get Tested?

Its generally thought that the majority of people with celiac disease remain undiagnosed (estimates vary, but some believe that 90% of cases arent identified), so it makes sense to be highly suspicious if you have certain types of digestive symptoms. These include abdominal bloating and pain, diarrhea, vomiting, gas, constipation and unexplained weight loss. Some folks should be especially on guard, said Dr. Murray, citing those who have a sibling, child, grandchild or indeed any other blood relative with known celiac disease. If any of those symptoms or categories describes you, you may want to ask your doctor to order a blood test for celiac disease. Dont first experiment with a gluten-free diet, since doing so can result in a false-negative result when you do get the test. And, speaking of false-negative results, these occur quite often with celiac disease, so if your test is negative but your symptoms persist, you may want to seek further evaluation.

People with celiac disease need to follow a gluten-free diet. You can obtain a list of foods to eat and foods to avoid by going to http://www.MayoClinic.com/health/celiac-disease/DS00319 or http://Digestive.niddk.nih.gov/ddiseases/pubs/celiac, which is the National Institute of Diabetes, Digestive, and Kidney Disorders (NIDDK) Web site. "The good news is, this diet works," said Dr. Murray. "Most older people with celiac disease do well after diagnosis -- in fact, 80% to 90% of patients feel completely better."

Source(s):

Joseph A. Murray, MD, gastroenterologist, professor of medicine, department of gastroenterology, Mayo Clinic, Rochester , Minnesota .
 
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