The evidence is clear that more and more people across the world are being diagnosed with coeliac disease. The NHS England National Centre for Refractory Coeliac Disease states clearly that ‘the incidence of coeliac disease has increased over the last two decades’. But how big is this increase, why is it happening, and is it simply a result of improved testing and greater awareness of the condition or is the disease itself on the rise?

How big is the rise?

There are several studies that show a steady rise in people being diagnosed with coeliac disease. Dr Benjamin Lebwohl conducted a review of existing literature for the Coeliac Disease Foundation and found that ‘the incidence of celiac disease has been rising since the second half of the 20th century into the 21st century in nearly every country where data on the disease are available’. 

The incidence of Coeliac disease is not just rising, it’s rising fast. Lebwohl’s data shows diagnosis rates have increased by an average of 7.5% per year over the past few decades. 

His findings were backed up by a second review by King et al, published in the American Journal of Gastroenterology, which showed that the prevalence of coeliac disease was on the rise across the world. 

But is coeliac disease itself actually on the increase, or is it simply that more people are being diagnosed with coeliac disease?

Improved diagnosis and awareness

Improved testing has certainly resulted in more people being diagnosed with coeliac disease. Blood tests for coeliac disease were first introduced towards the end of the last century, and they have become steadily more sensitive and more accurate since then. 

The awareness of the disease amongst both GPs and the general population has also improved, leading to the testing of patients with a wider range of symptoms. Understanding of the genetic links and the increased risks for close relatives has also led to increased screening rates. This has resulted in more people being diagnosed with coeliac disease, even when they have no symptoms.

However, better testing may only be part of the story. While one UK study theorised that a four-fold increase in incidence rates over 20 years ‘was due to improvements in the identification and diagnosis of coeliac disease over the study period’, a European study concluded that ‘the increase in new cases may (only) be partially due to improved diagnostic tools’. 

What else could be influencing coeliac disease?

Dr Balzora, a gastroenterologist at NYU Langone, thinks that our diet may be playing a role in the increasing numbers of people being diagnosed with coeliac disease. She says that ‘there are many theories about why celiac disease is on the rise. It could stem from changes in the way grains are grown or the ubiquity of gluten in today’s foods’.

Dr Elena Verdu, a professor and leading researcher into microbial therapeutics and nutrition in gastroenterology, thinks that changes in our gut microbes may also be having an effect. ‘Our data argues that the recognised increase in celiac disease prevalence in the general population over the last 50 years could be driven, at least in part, by perturbations in intestinal microbial ecology.’  

Dr. Robin G. Lorenz, of the University of Alabama at Birmingham, agrees, saying that Verdu’s findings ‘suggest the presence of Proteobacteria may play an important role in celiac disease pathology … somehow boosting the immune response to gluten’.

Glutafin are here for you

Whatever the reason behind the increase in the number of people being diagnosed with coeliac disease, it’s good to know that Glutafin are here to support coeliacs across the UK. From high quality gluten free foods on prescription, to tasty recipe ideas using those ingredients, from expert advice to helpful hints and tips, Glutafin’s support has been growing as fast as the disease itself. And we’re constantly looking for new ways to help people who have been diagnosed with coeliac disease and their family and friends.

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