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JOE MURRAY: Hello. My name is Joe Murray. I'm a gastroenterologist at the Mayo Clinic in Rochester, Minnesota. Today I'm talking to you about a paper that will be published in the Mayo Clinic Proceedings January 2017. It's entitled, Less Hiddin Celiac Disease But Increased Gluten Avoidance Without a Diagnosis in the United States: Findings From the National Health and Nutrition Examination Surveys From 2009 to 2014. This study, conceived by our colleagues at the NIDDK and ourselves, really aimed to study celiac disease in the US population.
The NHANES surveys are the best survey, or sampling, of the U.S. Population. The six year study was divided into three two year periods. And in this paper, we examined the trend over time of celiac disease, both diagnosed and undiagnosed. In the earliest part of this study, most patients, or people, with celiac disease in the United States remained undiagnosed. However, the last two year period, 2013 to 2014, that proportion of undiagnosed celiac disease had dropped to less than 50%, suggesting perhaps that we were, as a profession, finding a greater proportion of the people with celiac disease.
Why did this happen? I mean could be better tests, more awareness of the disease. In this figure from the paper, you can see that the proportion of undiagnosed celiac disease has shrunk substantially. The group with celiac disease that's been diagnosed has increased, but the largest increase is in the proportion of people who have avoided gluten without a diagnosis of celiac disease. What's hiding in this proportion? We don't know because when we conceived of this study, we had not been aware of this or at least there hadn't been this tremendous trend, or fashion, for avoiding gluten for perhaps other reasons. So that remains somewhat of a, let's say black box, but probably within that group, are people who have undiagnosed celiac disease and somehow or other haven't figured out to start avoiding gluten.
So it's also possible that this undiagnosed diagnose celiac disease has become let's say undiagnosable, because people have already started to avoid gluten without a diagnosis. So what message do I think comes from this paper? First, we're finding more celiac disease. We're diagnosing more celiac disease. And secondly, we need to test people before they go gluten free in order to be able to make an accurate diagnosis of celiac disease. And that's really a message that's not just pertinent to us in health care professions, gastroenterology for example, or internal medicine, or the primary care, but also to the general population. If you are thinking about avoiding gluten, please, and you have symptoms, please see your doctor and get tested for celiac disease first. Thank you.
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