On average, one in 100 people in the Netherlands has Celiac disease. That is about five million people across the European Union (M.L. Mearin, 2020). However, for every eight children in the Netherlands who actually have Celiac Disease, only one child is diagnosed (M.L. Mearin, 2020). Why is it that gluten intolerance is often not yet diagnosed? Do we simply not recognize the complaints yet? Or does this have other causes?
There is a diversity of complaints that people with Celiac disease experience. The most common are abdominal pain, diarrhea, weight loss, abdominal distension and in children, growth retardation is often visible (M.L. Mearin, 2020). In addition to complaints around the abdomen, there are patients who experience rheumatoid complaints, motor disorders, osteoporosis or anemia (M.L. Mearin, 2020).
Fatigue is also a common complaint and Celiac disease can be asymptomatic, which means that no complaints are noticeable at all (M.L. Mearin, 2020). The diversity of complaints or even the complete absence of them makes it difficult for physicians to diagnose Celiac disease. This could possibly be a reason why many people are undiagnosed. The actual number of people with Celiac disease may therefore be much higher.
Previously - well until 2012 - Celiac disease was only diagnosed via a small intestinal biopsy (M.L. Mearin, 2020). Fortunately, there is now a more friendly method to determine gluten intolerance, namely via a blood test (M.L. Mearin, 2020). In order to be allowed to carry out a blood test, it has been established since 2012 that a child must meet various conditions. For example, it must have symptoms indicative of Celiac disease, have HLA-DQ2 and/or DQ8 genes, TGA levels must be ten times or more normal and a second blood sample must have a positive EMA test (M.L. Mearin, 2020 ).
It appears that Celiac disease is partly hereditary. Celiac patients often have the HLA genes DQ2 and/or DQ8 (M.L. Mearin, 2020).
The Cyber Poli website states the following: "The hereditary predisposition to celiac disease is caused by the HLA gene, which is located on chromosome 6. People with the HLA type DQ2 or HLA type DQ8 can develop celiac disease. People who have this Not having the HLA type cannot develop celiac disease. About 40% of all Dutch people have the HLA-DQ2 and/or HLA-DQ8 gene, but only a small number develop celiac disease, around 0.5 to 3%." (Cyber Poli, n.d.).
Fortunately, more and more accurate research is being done these days. In addition, these tests are easier to perform (e.g. blood tests versus biopsy).
So there are indeed more children diagnosed with Celiac disease than before. We also notice this at events such as gluten-free markets, where children are increasingly walking around. We also often speak to parents of children who raise this issue. But the reason why it now seems as if there are more children with Celiac disease than before mainly has to do with the fact that there is simply more and better research being done into it than before.
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