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The prevalence of celiac disease (CD) in the U.S. is 0.71% (1 in 141) and most cases are undiagnosed, according to a recent study funded in part by the National Institutes of Health (NIH). The prevalence of CD varies by race and ethnicity, with a predominance among non-Hispanic whites. The prevalence is comparable to other population-based studies in several European countries.

“Researchers have estimated the rate of diagnosed and undiagnosed celiac disease prior to this study, but this is the most definitive study on this issue. This provides proof that this disease is common in the United States,” said Joseph A. Murray, M.D., co-senior author, and gastroenterologist at the Mayo Clinic , Rochester, MN.

Low Biopsy Rates Contribute to Underdiagnosis of Celiac Disease

According to a recent study published online in Gastrointestinal Endoscopy, low performance rates of small bowel biopsy during endoscopy for symptoms of celiac disease (CD) may be a factor in the under-diagnosis of CD in the United States. NIH-funded scientists studied the Clinical Outcomes Research Initiative National Endoscopy Database from 2004–2009. Biopsies during endoscopy were performed in 43 percent of patients. Biopsy rates were lower among older patients, males, blacks, and Hispanics.

Researchers anticipated that biopsy rates would be higher, considering the increased public awareness of celiac disease. Researchers noted that it remains possible for a patient with celiac disease to seek health care, see a gastroenterologist and have an endoscopy, and yet still remain undiagnosed.

Later Introduction of Gluten in Genetically Susceptible Infants May Delay Onset of Celiac Disease

A recent NIH-funded study showed that delaying gluten exposure until at least 12 months of age in infants at risk for celiac disease (CD) may help delay the onset of CD. The data suggest differences between the developing microbiota of infants with genetic predisposition for CD and infants with a non-selected genetic background. Data suggest that future research could potentially identify biomarkers to predict the development of celiac disease in at-risk individuals. These predictions could also lead to interventions that would potentially prevent the onset of celiac disease.