MYTH: Celiac Disease is rare in Canada so the physician does not need to know about it.
FACT: Though the incidence of Celiac Disease in Canada appears lower than in other countries such as the West of Ireland, where as many as 1 in 300 persons have the disease, it is not rare. For example, many thousands of Canadians with Celiac Disease belong to the Canadian Celiac Association.
MYTH: Celiac Disease is a disease of childhood.
FACT: Celiac Disease is frequently diagnosed for the first time in young adults, middle aged adults or senior citizens.
MYTH: Celiac Disease can be outgrown.
FACT: Celiac Disease is a lifelong condition. Although in some cases it is possible for Celiacs who are in remission after dietary treatment to take gluten without immediate obvious harm, it has been well shown that intestinal mucosal damage recurs and with time, severe clinical symptoms can develop.
MYTH: Celiac Disease is easily diagnosed.
FACT: It is more likely to be missed. The disease is a great mimicker and may present with constipation or abdominal pain or vomiting or anaemia and not with the classical text book symptoms of diarrhoea, weight loss (or failure to grow) and steatorrhoea (fatty stools).
MYTH: Celiac Disease can be diagnosed by a simple blood test.
FACT: The only current reliable test for Celiac Disease is an intestinal biopsy while the patient is still taking gluten. “Blood tests” are at best only screening tests and at worst can be misleading.
MYTH: An intestinal biopsy is a serious surgical procedure requiring general anaesthesia.
FACT: Performed by a skilled physician, a biopsy can be performed as a safe procedure with minimal discomfort, tolerated without general anaesthetic even by infants.
MYTH: A “trial” of the gluten free diet is a good way of selecting which patients may need a biopsy for celiac disease.
FACT: A gluten free diet “trial” before intestinal biopsy can seriously jeopardize or prolong the time needed to reach a definitive diagnosis. With the diet, the diagnostic intestinal mucosal lesions improve and may remain non-diagnostic for prolonged periods, even after reintroduction of gluten. Patients may “respond” clinically to dietary changes for reasons other than Celiac Disease.Conversely, some Celiacs may have a questionable response to the diet.
MYTH: A person with Celiac Disease can tolerate a small amount of dietary gluten once in a while.
FACT: Although the Celiac may appear well, serious damage to the intestinal villi can occur even with small amounts of gluten.
MYTH: The only dietary advice needed by a Celiac is to avoid wheat and wheat products.
FACT: Effective treatment of Celiac Disease requires strict exclusion of gluten from the diet for life. Many foods unexpectedly contain gluten and expert dietary instruction is essential, if the person with Celiac Disease is to avoid all sources of gluten and yet maintain a balanced and nutritious dietary intake. Gluten is found in wheat, rye, barley, oats and triticale and any parts thereof.
MYTH: Celiac Disease and Dermatitis Herpetiformis are unrelated.
FACT: Persons with Dermatitis Herpetiformis can present with obvious signs and symptoms of Celiac Disease or be asymptomatic, but have a positive intestinal biopsy. Treatment with a gluten-free diet helps control the Dermatitis Herpetiformis rash.
MYTH: After diagnosis and prescription of diet, the Celiac can be considered “cured” and need no further medical or dietary supervision.
FACT: Some medical problems such as iron deficiency anaemia may remain and need treatment. It is not yet clear whether late complications such as malignancy may occur, even after dietary treatment. Continued dietary advice and support is also essential to help the person cope with changing formulations of prepared foods.