One in 100 people in north India suffer from celiac disease, a disorder in which the lining of the small intestine is damaged when foods with gluten such as wheat, rye, and barley are eaten, AIIMS’ doctors said. Celiac disease is an autoimmune disease that occurs due to ingestion of a protein called gluten which is present in cereals. In these patients, the gluten protein is not digested completely leading to damage to the small intestinal mucosa where food is absorbed. The damaged small intestine does not absorb the food and thus, the patients fail to grow in height or gain weight and develop chronic diarrhoea, anemia (lack of blood), and weakness of bones, said Dr Govind Makharia, professor of Department of Gastroenterology and Human Nutrition at AIIMS. The AIIMS doctors conducted a study which covered 23,000 people out of which 0.6 per cent (1 in 160) had celiac disease. It was more common in the northern part of India (1.2 per cent) as compared to north eastern (0.8 per cent) and southern part (0.1 per cent).
According to Makharia, approximately one-third of Indians have genetic susceptibility to develop celiac disease and the only treatment is to avoid food items made from wheat. “100 gm of wheat contains 80 per cent of gluten protein. Around 50 mg of gluten which is equivalent to a bite of a chappati may be harmful to patients suffering from celiac disease,” the doctor said at the 17th International Celiac Disease Symposium.
Celiac disease is not reported extensively in India, Makharia said, adding that the biggest impediment in its prevention and treatment was the limited awareness about the disease and its causes. It is for the first time that this international symposium was being organised and it would provide insights, perspectives to the disease and help in making further breakthroughs on the research being done in this area.
“The need of the hour is both research and creating awareness about the condition. Overall, celiac disease has now become a disease of public health importance,” he said. Dr B S Ramakrishna Director, Institute of Gastroenterology, SIMS Hospital, Chennai, said a lot was happening in the area of research on celiac disease. “There are many highly sensitive and specific serological tests, anti-endomysial antibody and anti-tissue transglutaminase antibody assays, available today which can help in the detection of this condition,” he said.
However, it was alarming to note that currently only those with the most typical manifestations were checked and ultimately diagnosed with the disease, he said. Screening programmes within populations indicated that the disease was under-diagnosed and what was clinically detected represents only the tip of the iceberg. Management of celiac disease involves a gluten-free diet primarily, he added.