The gap between prevalence and diagnosis of celiac disease underscores the urgent need for heightened awareness and improved diagnostics

Traditionally thought to be uncommon in Asia, recent studies, including those conducted by AIIMS, have shed light on the prevalence of celiac disease in many Asian countries. In India alone, an estimated 6 to 8 million people are believed to be living with the condition, yet only a fraction have received a formal diagnosis. This alarming gap between prevalence and diagnosis underscores the urgency for increased awareness and enhanced diagnostic and treatment capabilities.Celiac disease, also known as celiac sprue or gluten-sensitive enteropathy, is a chronic autoimmune disorder that affects the small intestine. It is triggered by the ingestion of dietary gluten, a protein found in wheat and barley.

When individuals with celiac disease consume gluten, their immune system responds by damaging the lining of the small intestine, leading to various gastrointestinal symptoms and potentially causing long-term health complications. Celiac disease affects approximately one per cent of the global population, although many cases remain undiagnosed. The condition can manifest at any age, from infancy to late adulthood and can affect both genders. However, women are more prone to develop celiac disease. The first Asian Pacific Celiac Disease Symposium (APCDS 2024) commenced in New Delhi, focusing on the critical aspects of management, diagnosis and treatment of Celiac Disease. 

The symposium, organised by AIIMS in collaboration with the Asia Pacific Association of Gastroenterology (APAGE) and the International Society for the Study of Celiac Disease (ISSCD), marks a pivotal moment in the fight against this autoimmune disorder. APCDS 2024 serves as a platform for leading experts, healthcare professionals, and stakeholders to address the growing prevalence of celiac disease in the Asia-Pacific region. Given the observed increase in cases across Asian countries. The establishment of timely diagnosis and management systems is crucial. Dr. Govind Makharia, Professor in the Department of Gastroenterology and Human Nutrition at AIIMS, highlighted the significance of the disease, “there is a need for concerted efforts to increase awareness and enhance diagnostic and treatment capabilities. Celiac disease knows no borders, and the symposium has emphasised the necessity for a united front in addressing this global health issue.” Individuals with celiac disease may experience a range of symptoms, including:

Digestive Issues: These can include diarrhoea, constipation, abdominal pain, bloating and nausea.

Malnutrition: Damage to the small intestine can impair nutrient absorption, leading to deficiencies in vitamins, minerals, and other essential nutrients. This can result in fatigue, weight loss, anaemia and stunted growth.

Skin Problems: Some individuals with celiac disease may develop dermatitis herpetiformis, a skin rash characterised by itchy blisters.

Joint Pain: Celiac disease has been associated with joint pain and inflammation.

Neurological Symptoms: In some cases, celiac disease can cause headaches, numbness, and tingling sensations. The primary treatment for celiac disease is strict adherence to a gluten-free diet.

Along with the scientific programme in APCDS 2024, a workshop for dietitians was also organised to create infrastructure for celiac disease. Since dietitians are central in the treatment of celiac disease, it is necessary to have dietitians with in-depth knowledge about celiac disease and gluten free diet. The aim was to sensitise them with different challenges faced by patients and how to overcome them. Also, a workshop for patients was conducted to educate them about the disease and treatment protocol. Group counselling sessions were conducted by a team of dietitians and patients queries were answered.

(The author is consultant Celiac dietician, AIIMS; views are personal)