The unknown burden and cost of celiac disease in the U.S

ABSTRACT

Introduction: Celiac disease is an autoimmune disease that results from exposure to gluten in genetically susceptible individuals and leads to a range of gastrointestinal and extraintestinal symptoms. Areas covered: In order to evaluate the literature with respect to burden associated with celiac disease in the U.S. and identify any knowledge gaps, we performed a literature review of journal articles published between 2000–2016. We note that celiac disease is a prevalent condition associated with a significant burden of disease through its impact on morbidity, quality of life, as well as through increased costs associated with its diagnosis and management. At the same time, knowledge gaps exist in our understanding of the precise epidemiologic burden in the U.S.; the trade-offs between burden and benefit of a gluten-free diet; and better estimation of the costs of diagnosis, treatment and management.Expert commentary: Additional research is necessary to better understand these gaps to be able to reduce burden of celiac disease, particularly the impact on health-related quality of life and the costs associated with inaccurate or delayed diagnoses and insufficient treatment of disease.

KEYWORDS:

• Celiac disease
• gluten
• burden of disease
• cost of illness
• quality of life

Acknowledgments

The authors wish to acknowledge the valuable feedback provided by the following individuals in preparation of this manuscript: Peter Green, Benjamin Lebwohl, Alice Bast, Daniel Leffler, and Robert Anderson. Douglas Mogul is the guarantor of the article, and takes responsibility for the integrity of the work as a whole, from inception to published article. All authors were responsible for evaluating articles for inclusion into this review, writing, and editing of the manuscript. All authors approved the final version of the manuscript.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.