The occurrence of gluten intolerance in the Finnish population has doubled in the past twenty years. In the early 1980s, about one per cent of adults in Finland had gluten intolerance, but the figure has since gone up to two per cent by the 2000s.
"We've already seen a similar trend emerge earlier on where allergies and certain autoimmune disorders are concerned. Screening has shown that gluten intolerance occurs in 1.5 per cent of Finnish children and 2.7 per cent of the elderly. The higher figure for older people is explained by the fact that the condition becomes more frequent with age," says Professor Markku Mäki. Mäki has set up an internationally acclaimed research team on gluten intolerance, developing screening tests for gluten intolerance. Mäki is head of a research project in the Academy of Finland's Research Programme on Nutrition, Food and Health (ELVIRA).
According to Mäki, gluten intolerance may often be symptom-free, and people may be unaware that they have the condition if their symptoms are mild or atypical. Three out of four people with gluten intolerance have not been diagnosed, which also means that they are as yet going without treatment.
Better diagnosis methods needed
Mäki's research team has concluded that the criteria for diagnosing gluten intolerance must be rewritten, since early stages of the condition do not meet the criteria, yet is important to treat. The current criteria for diagnosis focus on damage to the intestinal villi and the small intestine, established in a tissue sample from the small intestine. However, early stages of gluten intolerance are not identifiable from tissue samples.
People may suffer from gluten intolerance, yet have no intestinal symptoms. They may, however, have symptoms unrelated to the intestinal tract. Serious problems with nutrient absorption have become rare; instead, sufferers generally have anaemia due to iron deficiency or folic acid deficiency as their main symptom. If researchers manage to develop sensitive, accurate antibody tests, it will become possible to identify people with early stages of gluten intolerance, who are in need of further treatment. At present, there is no single test to reliably identify early stages of gluten intolerance.
Sufferers are hoping for a diagnosis method that does not involve endoscopy. Researchers are hard at work, looking for new and better markers for gluten intolerance to allow for easier diagnosis of the condition.
Patients are also hoping for an 'anti-gluten pill'. Mäki says that some form of pill with enzymes that break down gluten may prove feasible in the future.