Are Estimates of Celiac Disease Rates Too High?

Dr. Fasano can be credited for the current gold-standard of celiac disease diagnosis confirmation using endoscopy. Now that he's backing off that, saying that sera confirmation appears to be enough...where does that leave this estimation?

I was told that the only true exact diagnosis was biopsy. Serology in my case every time did not show celiac disease, however biopsy with a second opinion did, on the other hand a second biopsy showed leukocytic colitis and then my doctor told me I only had IBS. So what is the real truth in this matter?

This is a rubbish study - the biopsy has repeatedly been shown to be a crap tool to assess the severity of coeliac disease - and bunching a handful of studies together proves absolutely nothing when populations have such markedly different rates of coeliac disease (as was actually stated in the article). And this makes complete sense when you look at the genetic markers which vary considerably from population to population. On top of which doctors are stupid - they treat their patients like idiots - without even realising that they're ruining their own tests by not clearly ensuring the patient is ingesting significant amounts of gluten in the lead up to the test. On top of which what person in their right mind would let a doctor biopsy them after they've had a blood test that's 99- 100 percent specific. Yes, the blood test is a terrible screening test - but it is because it misses about 20% of full blown coeliacs - not because it is over-diagnosing the condition. So Viki ignore your blood test - you have celiac - because of this high false negative rate a positive biopsy trumps a negative blood test every time - in the same way that a positive blood test should trump a negative biopsy - because even good doctors can miss the specific patch that shows coeliac damage - and bad doctors and inexperienced doctors have a success rate that is astoundingly low.

So the whole "Gold standard" thing is a load of croc designed to lower rates of coeliac - not only does it increase the number of people opting out of testing but there's also a reasonable chance of a false negative further artificially reducing the "coeliac" population. To get a real handle on all this we need to roll on AGA testing as the traditional concept of "Coeliac" is being proven to be more and more a construct of the belief that the condition of coeliac is rare - instead of the product of scientific evidence.

This is a rubbish study - the biopsy has repeatedly been shown to be a crap tool to assess the severity of coeliac disease - and bunching a handful of studies together proves absolutely nothing when populations have such markedly different rates of coeliac disease (as was actually stated in the article). And this makes complete sense when you look at the genetic markers which vary considerably from population to population. On top of which doctors are stupid - they treat their patients like idiots - without even realising that they're ruining their own tests by not clearly ensuring the patient is ingesting significant amounts of gluten in the lead up to the test. On top of which what person in their right mind would let a doctor biopsy them after they've had a blood test that's 99- 100 percent specific. Yes, the blood test is a terrible screening test - but it is because it misses about 20% of full blown coeliacs - not because it is over-diagnosing the condition. So Viki ignore your blood test - you have celiac - because of this high false negative rate a positive biopsy trumps a negative blood test every time - in the same way that a positive blood test should trump a negative biopsy - because even good doctors can miss the specific patch that shows coeliac damage - and bad doctors and inexperienced doctors have a success rate that is astoundingly low.

 

So the whole "Gold standard" thing is a load of croc designed to lower rates of coeliac - not only does it increase the number of people opting out of testing but there's also a reasonable chance of a false negative further artificially reducing the "coeliac" population. To get a real handle on all this we need to roll on AGA testing as the traditional concept of "Coeliac" is being proven to be more and more a construct of the belief that the condition of coeliac is rare - instead of the product of scientific evidence.

A j, you sound like a cranky bitter person, upset with your diagnosis and hoping the rest of the world is just as screwed as you are. A high Ttg is not specific to celiac and can be indicative of other autoimmune disorders. Why would someone with celiac show no immune response in their blood? Why, unless the celiac is very recently activated, would someone with the disease show no sign of damaged villi? There is no big conspiracy theory here! Why the hell would doctors want to "artificially lower" celiac rates?? You need to accept the fact that doctors aren't all out to get us, and that if someone says they have celiac and their doctor says they don't, they have every right to go to another doctor or cut gluten anyway. Ever heard of gluten sensitivity? Just because gluten makes someone feel bad does not mean they have celiac disease! Accept your diagnosis and stop acting like the world is against you. An increased number of gluten free products on the shelves and increased volume of research popping up looking for cures and treatments shows that people are taking this disease seriously, and no conspiracy is at play.