Should Adults be Screened for Celiac Disease?

There are certain criteria for screening patients for certain diseases. For example, in Italy, children are screened for celiac disease by the time they are 6 years old. The World Health Organization says that a disease should meet these criteria for mass screening: early clinical detection is difficult, the condition is common, screening tests are highly sensitive and specific effective treatment is available. Also, if left untreated the disease can lead to complications.
Celiac disease does meet this criteria in that celiac does affect 1 in 100 people. Patients, however remain undetected or there is a delay in diagnosis. And of course treatment is available: A gluten free diet. Although there has been much research to prove that in fact there should be a mass screening for celiac disease, it still is not implemented in this country.
Personally I would love for there to be a required screening, maybe during a 10 year old or 15 year old doctor check up, just so that my girls could know that they are not the only ones out there who are allergic or sensitive to gluten or even celiac as the case may be, they just know they are and the rest of their friends don’t know. Again, statistics show that in the U.S. we currently are diagnosing only 5% of our celiac patients, and so providing a mass screening procedure could only help to elevate these low numbers.
In addition to poor screening for celiac, research has shown that during a 15 year period in the United States, celiac disease prevalence has increased two fold and has increase 5 fold since 1974. That means that the incidence of celiac disease in the US doubles every 15 years. This trend has been observed in other countries as well, including Finland.
This might suggest to us that celiac disease is on the rise and that it increases with age. Since you are not necessarily born with celiac disease, the rise in occurrence may be correlated with an increase in age of the patients. This may sound contradictory to the idea that disease is inherited. But many autoimmune diseases are triggered by a particular tragic or significant event during their lives. Which makes sense in that patients frequently report that they have been very tolerant of gluten until a particular event occurred in their life. That event could have been giving birth to a child, a surgery, or a bad infection.
Unfortunately, autoimmune disease is the third most common disease category in the U.S. behind heart disease and cancer. It would make sense that we would find some way to screen for it in order to prevent complications from the disease. And while we know that heredity does play a factor in autoimmune disease, we also know that the environment does as well. It turns out that the health of the small intestine often plays a role in the health of the patient. In fact, where there’s one autoimmune disease, there is often more. We now know that celiac disease is associated with type 1 diabetes, rheumatoid arthritis and multiple sclerosis, just to name a few.
So by screening patients later on in life for celiac disease and applying a valid treatment plan, by eliminating gluten from the diet, you are essentially preventing the patient from developing other autoimmune diseases later in life. Although reasons for screening are valid, it is not our choice as to whether a mass screening will take place. In the meantime, we need to be proactive in our health, and ask to be screened. This can be done through your doctor or nurse practitioner, or you can simple go on line to, and order tests for yourself. If you suspect YOU might be celiac, because out of 100 subscribers of my articles, ONE of you is, and it is not me!
I chose this article for this week, as I was featuring the adults. I always write about kid issues and follow with kid recipes. This recipe is for the adult palate. It is pretty labor intensive. I double the recipe and freeze for an easy meal on a cold fall evening.
Vegetarian Moussaka
1 eggplant sliced
1 zucchini sliced
2 potatoes sliced
1 onion sliced
1 tsp minced garlic
1 can fire roasted tomatoes
7 oz lentils with juices
1 tsp oregano
1 cup parmesan cheese
2 Tbs olive oil
2 Tbs gluten free flour
1 ¼ cup lowfat milk
1/8 tsp nutmeg
1 egg, beaten
¼ cup grated Parmesan cheese

Simmer lentils in 4 cups of water for 40 minutes. Set aside.
Sprinkle eggplant with salt and let sit for 30 minutes. Rinse eggplant.
Preheat oven to 375 degrees.
In a pan brown eggplant and zucchini. Remove from pan. Repeat with potatoes.
Saute garlic and onions until browned. Add tomatoes, lentils and oregano.
Cover and simmer on medium low heat for 15 minutes.
In a 9 X 13 baking dish place a layer of eggplant, zucchini, potatoes, onions and feta cheese.
Pour some tomato and lentil mixture over vegetable slices.
Add another layer of vegetables, then sauce. Top with layer of vegetables.
Bake for 25 minutes.
To make the topping, mix olive oil, milk and flour and bring to a boil while whisking.
When it thickens, add nutmeg.
Remove from heat and cool 5 minutes. Mix in the egg.
Remove casserole out of oven and add topping.
Top with Parmesan cheese and bake for another 30 minutes.
Take out of oven and cool for 15 minutes
Slice and serve. Makes 12 servings.

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