Celiac disease involves far more than having bloating or diarrhea when gluten is consumed. If left undiagnosed or untreated, it can affect multiple organs including the heart, liver, thyroid, skin and bones and joints. It can be an underlying cause of osteoporosis, miscarriages and fertility issues, It can even lead to certain types of cancer.
“Early diagnosis is key,” said Dr. Jeffrey Gelwan, a gastroenterologist and Celiac program lead with Hartford HealthCare and Connecticut GI. The challenge is that celiac disease has changed over the last 30 years from a rare condition to one that affects up to 3 percent of all Americans. Its presentation has also changed significantly, and the majority of cases have a range of symptoms including anemia, peripheral neuropathy, and infertility. Today fewer than 45 percent of adult patients have the classic presentation of weight loss and diarrhea.
“Our goal is to capture all the (celiac) patients,” Gelwan said. “The asymptomatic patients, those with atypical symptoms, those with classic symptoms, as well as those at risk for celiac disease because of either family history or the presence of other associated diseases (diabetes, thyroid disease, etc.).”
ConnecticutGI and Hartford HealthCare recognize the need to educate both the general public and potential referring physicians (which can include primary care and specialist providers) to the symptoms that should trigger a test for celiac disease. As part of that work to raise awareness of the disease, its myriad symptoms, and its potential effects, Connecticut GI has achieved the designation of a Celiac Disease Center of Excellence from the Society for the Study of Celiac Disease. It is one of only seven in the United States, and the only one between New York and Boston.
The recognition is bestowed on practices that demonstrate a commitment to diagnosing and treating celiac disease through their policies, credentialing, staff training and competencies. Among others with the designation in the United States are Harvard University Medical School, Columbia University, University of Chicago and Vanderbilt.
“For us to be part of this group and be recognized by this group, is a reflection of the quality of the care we provide,” Gelwan said. “And it’s also a great resource for us.”
In addition to having 15 providers with special knowledge of celiac, the team also includes two GI pathologists and two nutritionists who work with the providers and patients on diagnosis and treatment plans. Gelwan said this gives each patient access to comprehensive care when it comes to treating their disease and alleviating their symptoms.
“Celiac is a chronic disease that results from an inappropriate immune response to the dietary protein gluten,” he said. “In most cases, it’s relatively simple to treat — we remove gluten from the diet. It’s the diagnosis that proves challenging, and that’s what we are focusing on now — educating our patients, educating the referring doctors, and educating our own physicians.”
