The prevalence of celiac disease in the general population was believed to be 1 in 300, but recent evidence suggests that there are more undiagnosed than diagnosed cases. A revised estimate of the prevalence in the general population may be as high as 1%. The prevalence of CD among first-degree relatives of people who are diagnosed with CD is as high as 15%. In families with sibling pairs affected by CD, the prevalence of CD is 21.3% in siblings, 14.7% in offspring, 17.2% in first-degree relatives, 19.5% in second-degree relatives, and 17.8% in all relatives. [i]

We believe that the prevalence of all forms of gluten allergy may be closer to 20%. Most gluten-sensitive patients have not been diagnosed. We argue that any person with celiac-like symptoms should do diet revision right away and not worry about an exact diagnosis.

Catassi et al suggested: “Many cases of celiac disease are currently undiagnosed. We carried out a pilot study on screening for celiac disease in a school population. The ratio of known to undiagnosed cases was 1 to 6.4. This high prevalence of undiagnosed celiac disease raises a number of problems that require further evaluation.“

Corazza and Gasbarrini suggested: “Since it has been demonstrated that a strict gluten-free diet is protective against the complications of adult celiac disease, it is important that even subclinical and silent forms are diagnosed and treated as early as possible."

Ciacci et al ^[ii] suggested that celiac disease may present in various forms. Their study showed that the disease is more frequent in women, more severe and develops more rapidly. They stated:

"The data also suggest the need to look for celiac disease in patients with unexplained anemia. Except for asthenia, all signs and symptoms were more frequent in women than in men. Anemia was the commonest finding in women and was 40% more frequent in women than in men. Dyspepsia was twice as frequent in women as in men. Genital disorders were reported by 44% of women and by no men. Recent weight loss or low body mass index was the commonest finding in men. About 60% of men and women reported diarrhea; among patients without diarrhea, the prevalence of anemia differed between sexes, occurring in about 80% of women."

Biopsy Not Required

Our argument is that gluten-caused disease and the diagnosis of gluten allergy should not depend on intestinal biopsy. The biopsy reveals only one pathological manifestation of gluten allergy. We recommend gluten elimination in all digestive tract disorders and in all the conditions that a commonly related to celiac disease. Our theory is that gluten proteins produce a number of diseases that overlap and are only occasionally manifest as well-defined, discrete disorders.

The diagnosis of celiac disease is, therefore, an arbitrary separation of one small subgroup within a much larger group that suffers disease when they eat gluten. Our assumption is that if you look at symptomatic populations with gastrointestinal symptoms and/or autoimmune disease, then the incidence of gluten sensitivity will be higher than expected. Since a strict gluten-free diet is protective against the consequences of gluten allergy, it is important that undiagnosed forms of celiac disease and non-celiac "gluten allergy" are treated with diet revision.

Immune responses to gluten, the proteins found in cereal grains are a common cause of disease. The gastrointestinal tract is the primary target organ; however systemic disease is an important consequence of cereal grain ingestion in many patients. We think that the people diagnosed with celiac disease are a sub-population of a much larger group with gluten allergy. Latent disease may manifest as irritable bowel syndrome, sometimes with iron deficiency anemia, but little or no diarrhea. Celiac disease is associated with a variety of autoimmune disorders, carcinomas of the gastrointestinal tract and lymphomas.

Troncone et al * stated: "Gluten-sensitive enteropathy is induced by dietary wheat gliadin and related proteins in genetically susceptible individuals. Most evidence suggests an immunologically mediated injury triggered by gluten … it is now becoming clear that a greater proportion of individuals has clinically silent disease, and probably many others have a minor form of the enteropathy. In most countries, the clinical presentation has changed over the past few years coming closer to the adult type of the disease, and the age of onset of symptoms is shifting upward.

Recommendations: The Alpha Nutrition Program is gluten-free and is recommended as the diet revision strategy for anyone with diagnosed celiac disease, or any person with symptoms suggestive of gluten allergy.  The diet revision program is explained in enough detail in the Alpha Nutrition Program Manual  that an intelligent, well-motivated person can follow the steps outlined. You can order the manual and the Book of Celiac together in the starter pack.

Alpha Nutrient Formulas are gluten free. Please note that maltodextrin, used in Alpha ENF and Alpha PMX, does not contain gluten and is not related to barley-derived malt.

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