The prevalence of celiac disease in the United States.
ABSTRACT The prevalence of celiac disease (CD) in the United States is unknown. We sought to estimate CD prevalence nationwide by using a nationally representative sample.
This study included 7,798 persons aged 6 years or older who participated in the National Health and Nutrition Examination Survey 2009-2010. Serum samples from all participants were tested for immunoglobulin A (IgA) tissue transglutaminase antibodies and, if findings were abnormal, also for IgA endomysial antibodies. Information about prior diagnosis of CD and use of a gluten-free diet (GFD) was obtained by direct interview. CD was defined as having either double-positive serology (serologically diagnosed CD) or a reported diagnosis of CD by a doctor or other health-care professional and being on a GFD (reported clinical diagnosis of CD).
CD was found in 35 participants, 29 of whom were unaware of their diagnosis. Median age was 45 years (interquartile range, 23-66 years); 20 were women and 29 were non-Hispanic white. The prevalence of CD in the United States was 0.71% (95% confidence interval (CI), 0.58-0.86%), with 1.01% (95% CI, 0.78-1.31%) among non-Hispanic whites. In all, 55 participants reported following a GFD, which corresponded to a prevalence of 0.63% (95% CI, 0.36-1.07%).
The prevalence of CD in the United States was 0.71% (1 in 141), similar to that found in several European countries. However, most cases were undiagnosed. CD was rare among minority groups but affected 1% of non-Hispanic whites. Most persons who were following a GFD did not have a diagnosis of CD.
- SourceAvailable from: Jose M Remes-Troche[Show abstract] [Hide abstract]
ABSTRACT: Background Celiac disease (CD) is a global health problem and its prevalence is underestimated, especially in Latin American populations. Our aim was to evaluate the clinical features, psychological factors, and health-related quality of life (QoL), before and after diagnosis, in a representative sample of adult Mexican Mestizo patients presenting with CD.MethodsA cross-sectional analysis was conducted on patients seen at two tertiary referral centers in Mexico. QoL before and after CD diagnosis was evaluated using the EuroQoL 5D, the Hospital Anxiety and Depression Scale (HADS), and the disease-specific Celiac Symptom Index (CSI) questionnaires.ResultsWe included 80 patients (80% were women, with a mean age of 48.6¿±¿14.1 years). The most common symptoms were diarrhea (86%), bloating (77.5%), and abdominal pain (71.3%). Mean symptom duration was 10.33¿±¿6.3 years. Fifty-one patients (63.8%) had a previous diagnosis of irritable bowel syndrome (IBS) and 23 (28.8%) had one of functional dyspepsia. Questionnaire respondents rated their health status at 50% before diagnosis (0¿=¿worst imaginable state, 100¿=¿best imaginable state) and there was a significant improvement of 26% after diagnosis. Thirty-nine percent of the patients had a CSI score¿>¿45 and they were the ones that had been previously diagnosed most often with IBS (p¿=¿0.13) or dyspepsia (p¿=¿.036).Conclusions At the time of diagnosis, Mexican Mestizo patients with CD had poor QoL. Long-standing symptoms and a previous diagnosis of functional disorders were associated with worse QoL. As in other populations, our results support the need for a detailed examination of cost-effective strategies for increasing CD awareness in clinical practice.BMC Gastroenterology 01/2015; 15(1):4. · 2.11 Impact Factor
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ABSTRACT: Evidence shows that there is a significant impact of having a sibling with a chronic illness. However there is no literature regarding this phenomenon in siblings of heart transplant (HTx) recipients. Adolescence is an intense stage of development which may amplify stressful experiences. The purpose of this study was to explore the impact of having a sibling with a HTx during the vulnerable period of adolescence.Methods and MaterialsQualitative methodology was used to understand the perceptions and experiences of adolsecents who have a sibling with a HTx. Data collection included a semi-structured focus group interview with adolescent siblings of HTx recipients. A phenomenological theoretical framework guided data collection and analysis.ResultsSix adolescent siblings, (mean age 15(±1.8) yrs, 5 males) of HTx recipients participated in a focus group discussion. Participants siblings were 7.4 (± 7.0) yrs old and 3.0(±5.3) yrs post transplant at the time of the study. Focus group transcript review revealed consistent themes involving various domains of social and psychological functioning. The adolescent participants universally expressed feelings of protectiveness for their sibling – from both physical and emotional harm. Study participants also identified disruption in family functioning and daily activities as stressors that were heightened during periods of the siblings’ acute illness. Specific areas of disruption included school routines, living arrangements and parental stress and availability.Conclusions This qualitative study reveals important themes regarding the impact of having a sibling with a HTx on adolescents. Increased attention to sibling needs is indicated. This may include counseling to explore feelings of responsibility for the ill sibling and strategies to minimize the disruption of family routines and relationships during acute illness. Further research is required to examine such interventions.The Journal of Heart and Lung Transplantation 04/2013; 32(4):S195. · 5.61 Impact Factor
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ABSTRACT: Celiac disease (CD) is a chronic inflammatory disease of the small intestine triggered by gluten ingestion. The objective of this study is to describe our experience with CD children in Kuwait. The records of children with CD seen in the pediatric gastroenterology unit between February 1998 and December 2010 were retrospectively reviewed. Patients were referred because of symptoms or positive CD antibody screening of a high-risk group (type 1 diabetes and Down syndrome). Forty-seven patients were diagnosed: 53% were symptomatic and 47% were identified by screening. The median age at diagnosis was 66 (range 7-189) months. All cases were biopsy-proven except one. The symptomatic patients were significantly younger than those identified following screening (P<0.004). In the whole group, 66% were females and 77% were Kuwaitis; 9% had a positive family history of CD. The estimated cumulative incidence was 6.9/10(5). The median duration of symptoms before diagnosis was 8.5 (range 2-54) months. Failure to thrive was the most common presenting complaint (72%) followed by diarrhea (64%) and abdominal distension (56%). Atypical manifestations were seen in 60% of patients. Underweight and short stature were confirmed in 19% and 17% of patients, respectively. Overweight and obesity were detected in 14% and 6%, respectively. CD serology was based on a combination of antiendomysial and antigliadin antibodies. The median follow up was 24 (range 12-144) months. All patients were commenced on a gluten free diet, but good compliance was only achieved in 78%. The low frequency of childhood CD in Kuwait could probably be attributed to either an underestimation of the atypical presentations or failure of proper screening. Also, adherence to a gluten free diet is a major problem in our population.Clinical and Experimental Gastroenterology 01/2015; 8:43-8.