1 in 100 people in North India suffer from Celiac Disease

Celiac Disease is a global disease and affects almost 0.7% of the world's population. In India, about six to eight million Indians are estimated to have this disease, and its prevalence in the North Indian community is 1 in 100.

In a bid to discuss and explore the best ways to address the challenges faced by patients with celiac disease and the way forward, the 17th International Celiac Disease Symposium (ICDS) is being organized from September 8-10, 2017.

ICDS is a platform for leading gastroenterologists, clinical scientists, nutritionists, and other relevant industry leaders from across the world to come together and address common challenges faced by patients living with celiac disease.

Delegates from 27 different countries including USA, Europe, Africa and Asia are expected to participate in it.

The symposium is being organized by the All India Institute of Medical Sciences (AIIMS) in association with the Indian Society of Gastroenterology (ISG), International Society for the Study of Celiac Disease (ISSCD), and the Asia-Pacific Association of Gastroenterology (APAGE).

Celiac disease is an autoimmune disease that occurs because of ingestion of a protein, called gluten, which is present in the cereals - wheat and barley. In these patients, the gluten protein is not digested completely and that leads to damage to the small intestinal mucosa (where food is absorbed).

With the damage of small intestine, the food is not absorbed and thus, these patients fail to grow in height and weight, develop chronic diarrhea, anemia (lack of blood), and weakness of bones.

Speaking about the symposium, Dr Govind Makharia, Organizing Chairman and Professor, Department of Gastroenterology and Human Nutrition, AllMS, New Delhi, said, "Celiac disease is not reported extensively in India. Celiac disease is more common than is recognized in our country. However, the biggest impediment in its prevention and treatment is the limited awareness about the disease and its causes. ICDS is a way forward in this direction. It is for the first time that this international symposium is being organized in Asia."

Adding, "It will help in providing many insights and perspectives to the disease and in making further breakthroughs on the research being done in this area. The country's preparedness towards the emerging epidemic of this disease is also minimal and therefore, the need of the hour is both research and creating awareness about the condition. Overall, celiac disease has now become a disease of public health importance."

The study conducted by AIIMS (Makharia GK, et al) in 2011 including 2879 subjects revealed that 1 in 100 have celiac disease (1.04%). Later in a country-wide study (multicenter) including 23,000 apparently healthy subjects, it was observed that 0.6% (1 in 160) had celiac disease, being more common in Northern part of India (1.2%; 1 in 90), and North-Eastern part of India (0.8%; 1 in 130) and much less common in Southern part of India (0.1%; 1 in 1000).

Adding further Prof. Bana Jabri, University of Chicago, Department of Medicine and Carlo Catassi, Professor Universita, Politecnicadele Marche, Ancona, Italy in a statement said, "Celiac disease is mostly thought of as a Western disease and has never been accorded importance in India/Asia. Although there has been an increase in the number of publications on this disease from the Asia Pacific region, there is a paucity of literature on its prevalence in most Asian nations, with the exception of Australia, New Zealand, Iran, and India."

Adding, "With population mixing now becoming more common, it should not be inappropriate to consider the whole world as a global village for celiac disease. Lack of awareness is a major impediment and due to this, it often goes undiagnosed. It has been found that genetics has a major role in the prevalence of this disease and therefore, children are equally susceptible to it. The need of the hour is to increase awareness among people and physicians alike. The challenges and opportunities are many and ICDS will prove to be the ideal platform in bringing some of these core concerns to the fore."

Dr B S Ramakrishna, Director, Institute of Gastroenterology, SIMS Hospital, Chennai, said, "Much is happening in the area of research on celiac disease. ICDS will throw light on some of these diagnostic advancements as well. There are many highly sensitive and specific serological tests, anti-endomysial antibody and anti-tissue transglutaminase antibody assays, available today which can help in the detection of this condition. However, it is alarming to note that currently, only those with the most typical manifestations are checked and ultimately diagnosed to have the disease. Screening programmes within populations indicate that celiac disease is under-diagnosed and what is clinically detected represents only the tip of the iceberg. Management of celiac disease involves a gluten-free diet primarily. Many other targets for control of the immune-pathogenesis of celiac disease are now actively explored, with many of them in the phase 2 and phase 3 clinical trials. It would be interesting to note developments around the world and align Indian strategies to manage this condition with those."

The symposium will address topics such as the role of a gluten-free diet in the treatment of Celiac Disease, revolutionary developments in treatment including the successes of clinic trials aiming at the control of the immune-pathogenesis of celiac disease, and clinical manifestations of the disease.

ICDS 2017 will also address ways towards treatment and management of the disease including creating increased awareness amongst health care professionals and the general public about the disease, team-based management of patients with celiac disease, proper counseling and supervision of patients, training of dieticians in the management of patients with celiac disease, industrial production of reliable and affordable gluten-free food, and food labeling for gluten contents. 

-ANI