Millennium Post

Celiac disease needs wide spread awareness: AIIMS

New Delhi: Experts from the All India Institute of Medical Sciences have now said that Celiac disease could likely be described as nearly being an epidemic in India as their studies have showed nearly 1 per cent of the population having the predisposing genetic markers for the disease.

A panel of doctors, including Dr Randeep Guleria, Director, AIIMS, Dr Anoop Saraya, HOD, Department of Gastroenterology and Dr Govind Makharia, Department of Gastroenterology said the disease –which is basically an allergic reaction to gluten –could be prevalent in around 60-80 lakh people in the country and is only now being discovered because of more diagnosis that have now become possible due to proper infrastructure.

The general concept of Celiac disease being prevalent only in the Western Hemisphere has also led to the prolonged misconception that it could not be found in India, said the doctors in a Press conference. Dr Saraya said that for a long time, doctors in India thought it was something only observed in children but there needs to be public awareness that it is an auto immune disease that manifests due to the presence of certain genetic markers in people of all ages and across the globe.

The disease occurs in people who carry the HLA DQ2/DQ8 gene and could manifest at any age. The doctors explained that gluten, a large part of the protein found in wheat and barley, is digested by the human body with the help of an enzyme called Tissue transglutaminase (TTG).

When a person develops this disease, their immune system creates anti-bodies that attack the TTG enzyme leading to the patient not being able to digest gluten at all. The AIIMS experts said that some common symptoms include persistent and unresponsive diarrhoea and anaemia and malabsorption.

Saying that the only way for someone with the disease to stay healthy is to avoid gluten in their diet, the doctors added that they had tested as many as 700 gluten-free products available in Indian markets and found that 85 per cent are safe to consume and healthy.

However, a more sombre finding from this study revealed that most of these products are way beyond the means of a large portion of the rural population who most commonly consume wheat and barley and are as likely to have the genetic markers for the disease as the urban population.

On the other hand, Dr Guleria said that the disease also has a certain social thinking attached to it that has prevented more diagnosis in India. He said that people in India generally associated the disease to something being restricted to the West which resulted in doctors not even considering Celiac as a possible diagnosis.

But due to better testing kits available now more cases are being diagnosed, he said, adding that the best way to confirm such a case would be to first identify the genetic markers and confirm the disease by a duodenal biopsy.

Dr Makharia added that the public should not entertain arguments that misrepresent the disease as being "imported from the West". Dr Saraya said that the disease has always been prevalent across the globe and is just now being discovered in India in large numbers.

In addition, the senior doctor said that neither is this disease caused by "modern wheat"; the disease can be triggered by gluten found in wheat that Indians have been consuming for thousands of years. Dr Saraya added that the government also needs to help spread awareness and take measures so that more gluten-free products are made available to a larger part of the populace.

He also said that governments and food manufacturers could go the extra mile to disclose whether products have gluten in them.

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