Celiac disease often undiagnosed in men

The autoimmune condition known as celiac disease is far more frequently diagnosed in women and girls than in men and boys. Celiac disease occurs in people who are genetically predisposed or with a family history of this condition. The condition is triggered when a person eats food containing gluten (a protein found in foods with wheat, barley, or rye). This ingestion of gluten leads to severe damage to the lining of the small intestine that inhibits the absorption of nutrients. The damage also leads to symptoms such as diarrhea, gas, bloating, and intense pain in the abdomen. Currently, about 1 in 100 people worldwide are affected by celiac disease, but it’s estimated only 30% of people are correctly diagnosed.

While it is true that autoimmune diseases, like celiac, are more commonly found in women than men, some studies have found that men may be under diagnosed with the condition. It’s believed that men have celiac at higher rates than expected and that the actual female to male ratio of celiac disease is 1.5 to 1. 

Symptoms of celiac disease in men

The symptoms of celiac disease in both men and women generally range from constipation, diarrhea, recurrent abdominal pain, and bloating. However, there are gender-specific symptoms unique to men:

• Gonadal dysfunction could complicate fertility 
• Changes within the semen such as number and mobility
• Men who are of short stature
• Men more likely to develop osteoporosis
• A condition called dermatitis herpetiformis that causes chronic, itchy, blistering skin

Diagnosing and treating celiac disease in men

Like any autoimmune disease, finding the condition early on is best. The earlier found, the greater chance of significantly improving a person’s overall quality of life. Celiac disease, found early and then treated, can immensely help lessen the damage to the small intestine’s lining.

Any man with the above symptoms, especially those with osteoporosis, should be tested for celiac disease. The first steps in testing for celiac are blood tests.  These blood tests can measure a man’s body’s response to gluten. 

Here are the blood tests currently used to help diagnose celiac disease:

• Total IgA
• IgA-tTG
• IgA-EMA
• If IgA is deficient, then the IgG/IgA-DGP is also ordered. 
• A doctor may also order IgG-AGA to confirm the diagnosis

It is essential for men (and women) not to be following a gluten-free diet before being tested. This will skew the results of the tests and waste time in getting an accurate diagnosis. 

Once an accurate diagnosis is made, a doctor will talk to a man about treatment. There are no medications or medical procedures that will treat Celiac disease. The only treatment is to follow a gluten-free diet for a lifetime.  This is the only way to relieve symptoms and heal damage to the small intestine. When people with Celiac disease follow a gluten-free diet, this helps prevent further intestinal damage in the small intestine and helps keep a person symptom-free. 

Asking a person to follow a gluten-free diet may sound fairly; however, it can be more challenging than people realize. Many unsuspecting foods, medications, communion wafers, lip balms, toothpaste, and even vitamin/mineral supplements that contain gluten. That’s why once a diagnosis of celiac disease has been made, the patient should automatically be referred to a registered dietitian who can help them plan meals, offer recipes, and provide valuable advice on avoiding foods with gluten.  

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.