The Canadian Journal of CME / September 2005 23

Celiac disease is an immune-mediated, malabsorptivedisorder of the small bowel mucosa, caused by exposure to dietary gluten in genetically predisposed individuals. How common is celiac disease? Celiac disease is an under-recognized entity that is more prevalent than previously thought. Population-based studies indicate a prevalence of 1:300 in Denmark, 1:184 in Italy and 1:152 in Ireland.1,2 In a study of asymptomatic blood donors, the prevalence is 1:133 in the US.2 Historically, celi-ac disease was considered restricted to individuals of Northern European background. However, studies from dif-ferent parts of the world have demonstrated similar high-prevalence rates in South America, India, parts of Africa and Asia. Family members of an affected individual are at increased risk for the disorder. The prevalence of celiac dis-ease is 1:22 in first-degree relatives and 1:39 in second-degree relatives.1 What are the presenting symptoms? Although historically a childrens’disease, celiac disease can affect individuals of any age. Children younger than two years tend to present with the more classic gastrointestinal (GI) symptoms of diarrhea, weight loss, malabsorption and failure to thrive. Older children and adults may present with these classic symptoms, but they more frequently have non-specific GI symptoms, non-GI symptoms or they can be asymptomatic. The symptoms of celiac disease can be similar to irrita-ble bowel syndrome (IBS) and recent studies have shown an increased prevalence of celiac disease in patients diagnose