Coeliac disease

Coeliac disease: prevalence and incidence
Celiac disease (formerly known as endemic sprue) is one of the most common autoimmune diseases worldwide. Its prevalence varies from country to country and, according to screening studies, ranges between 0.7% and 2.9%, with an average of around 1%. Women are more commonly affected than men, with a ratio of between 1:3 and 1:5:1. An increased prevalence is also seen in first-degree relatives (10-15%) and other risk groups, especially in people with other autoimmune diseases, Down syndrome, type 1 diabetes or IgA deficiency.
Why is the incidence of coeliac disease steadily increasing?
Bis vor wenigen Jahrzehnten galt Zöliakie als seltene Krankheit, die typisch für europäische Länder war, mit einer geschätzten Prävalenz von 1:4000-1:8000. Durch die Entwicklung sensitiver und einfacher diagnostischer Werkzeuge wie der serologischen Testung auf Gewebetransglutaminase (TTG) IgA-Antikörper und die Weiterentwicklung der Screeninguntersuchungen der letzten Jahre hat sich gezeigt, dass Zöliakie weitaus häufiger vorkommt als angenommen. Laut einer Metaanalyse aus dem Jahr 2020, hat die Inzidenz der Zöliakie in den letzten Jahrzenten um durchschnittlich 7,5% pro Jahr zugenommen. Die Gesamtinzidenz von Zöliakie in Europa liegt nun in den meisten europäischen Ländern über 12,7 pro 100.000.
What is the peak age for the manifestation of coeliac disease?
Coeliac disease can manifest itself at any stage of life, from early childhood to old age. There are two age peaks: the first occurs after gluten is introduced within the first two years of life, while the second is observed in the second or third decade of life.
Why do we talk about the coeliac disease diagnosis iceberg?
Only 10 to 20% of people with coeliac disease have the classic full-blown form of the condition. The majority of those affected have atypical symptoms, few or none at all, and are therefore often unaware of the disease. This is why it is often referred to as the coeliac disease iceberg. Despite increased awareness and improved diagnostic options in recent years, according to Coeliac UK, only 36% of cases in the UK are currently diagnosed. The mostly heterogeneous symptoms of coeliac disease are a particular factor in delaying diagnosis. According to an international online survey conducted by Dr. Schär's internal database, the average time between first visiting a healthcare professional to discuss symptoms, and the diagnosis of coeliac disease is 4.8 years.

Dr. Schär Institute Newsletter
Sharing GRD research and expertise for your practice: our newsletter keeps you up to date on coeliac disease and related topics.
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