Working Party Report
Issues associated with the emergence of coeliac disease in the Asia–Pacific region: A working party report of the World Gastroenterology Organization and the Asian Pacific Association of Gastroenterology
Govind K Makharia,
Chris J J Mulder,
Khean Lee Goh,
Vineet Ahuja,
Julio C Bai,
Carlo Catassi,
Peter H R Green,
Siddhartha Datta Gupta,
Knut E A Lundin,
Balakrishnan Siddartha Ramakrishna,
Ramakant Rawat,
Hanish Sharma,
Ajit Sood,
Chikako Watanabe,
Peter R Gibson,
World Gastroenterology Organization-Asia Pacific Association of Gastroenterology Working Party on Celiac Disease,
Corresponding Author
Govind K Makharia
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
Correspondence
Dr Govind K Makharia, Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India. Email: [email protected]; [email protected]
Search for more papers by this authorChris J J Mulder
Department of Gastroenterology & Hepatology, VU Medical Center, Amsterdam, Netherland
Search for more papers by this authorKhean Lee Goh
Department of Gastroenterology and Medicine, Malaya University, Kuala Lumpur, Malaysia
Search for more papers by this authorVineet Ahuja
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
Search for more papers by this authorJulio C Bai
Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires, Argentina
Search for more papers by this authorCarlo Catassi
Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy
Search for more papers by this authorPeter H R Green
Department of Clinical Medicine, Columbia University, New York, New York, USA
Search for more papers by this authorSiddhartha Datta Gupta
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
Search for more papers by this authorKnut E A Lundin
Department of Gastroenterology, University of Oslo, Oslo, Norway
Search for more papers by this authorBalakrishnan Siddartha Ramakrishna
Department of Gastroenterology, SRM Institute of Medical Sciences, Chennai, India
Search for more papers by this authorRamakant Rawat
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
Search for more papers by this authorHanish Sharma
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
Search for more papers by this authorAjit Sood
Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India
Search for more papers by this authorChikako Watanabe
Department of Internal Medicine (Gastroenterology Division), National Defense Medical College Tokorozawa, Saitama, Japan
Search for more papers by this authorPeter R Gibson
Department of Gastroenterology, Monash University and Alfred Health, Melbourne, Victoria, Australia
Search for more papers by this authorWorld Gastroenterology Organization-Asia Pacific Association of Gastroenterology Working Party on Celiac Disease
Search for more papers by this authorGovind K Makharia,
Chris J J Mulder,
Khean Lee Goh,
Vineet Ahuja,
Julio C Bai,
Carlo Catassi,
Peter H R Green,
Siddhartha Datta Gupta,
Knut E A Lundin,
Balakrishnan Siddartha Ramakrishna,
Ramakant Rawat,
Hanish Sharma,
Ajit Sood,
Chikako Watanabe,
Peter R Gibson,
World Gastroenterology Organization-Asia Pacific Association of Gastroenterology Working Party on Celiac Disease,
Corresponding Author
Govind K Makharia
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
Correspondence
Dr Govind K Makharia, Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India. Email: [email protected]; [email protected]
Search for more papers by this authorChris J J Mulder
Department of Gastroenterology & Hepatology, VU Medical Center, Amsterdam, Netherland
Search for more papers by this authorKhean Lee Goh
Department of Gastroenterology and Medicine, Malaya University, Kuala Lumpur, Malaysia
Search for more papers by this authorVineet Ahuja
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
Search for more papers by this authorJulio C Bai
Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires, Argentina
Search for more papers by this authorCarlo Catassi
Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy
Search for more papers by this authorPeter H R Green
Department of Clinical Medicine, Columbia University, New York, New York, USA
Search for more papers by this authorSiddhartha Datta Gupta
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
Search for more papers by this authorKnut E A Lundin
Department of Gastroenterology, University of Oslo, Oslo, Norway
Search for more papers by this authorBalakrishnan Siddartha Ramakrishna
Department of Gastroenterology, SRM Institute of Medical Sciences, Chennai, India
Search for more papers by this authorRamakant Rawat
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
Search for more papers by this authorHanish Sharma
Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
Search for more papers by this authorAjit Sood
Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India
Search for more papers by this authorChikako Watanabe
Department of Internal Medicine (Gastroenterology Division), National Defense Medical College Tokorozawa, Saitama, Japan
Search for more papers by this authorPeter R Gibson
Department of Gastroenterology, Monash University and Alfred Health, Melbourne, Victoria, Australia
Search for more papers by this authorWorld Gastroenterology Organization-Asia Pacific Association of Gastroenterology Working Party on Celiac Disease
Search for more papers by this authorAbstract
Background and Aim
Once thought to be uncommon in Asia, coeliac disease (CD) is now being increasingly recognized in Asia–Pacific region. In many Asian nations, CD is still considered to be either nonexistent or very rare. In recognition of such heterogeneity of knowledge and awareness, the World Gastroenterology Organization and the Asian Pacific Association of Gastroenterology commissioned a working party to address the key issues in emergence of CD in Asia.
Methods
A working group consisting of members from Asia–Pacific region, Europe, North America, and South America reviewed relevant existing literature with focus on those issues specific to Asia–Pacific region both in terms of what exists and what needs to be done.
Results
The working group identified the gaps in epidemiology, diagnosis, and management of CD in Asian–Pacific region and recommended the following: to establish prevalence of CD across region, increase in awareness about CD among physicians and patients, and recognition of atypical manifestations of CD. The challenges such as variability in performance of serological tests, lack of population-specific cut-offs values for a positive test, need for expert dietitians for proper counseling and supervision of patients, need for gluten-free infrastructure in food supply and creation of patient advocacy organizations were also emphasized.
Conclusions
Although absolute number of patients with CD at present is not very large, this number is expected to increase over the next few years or decades. It is thus appropriate that medical community across the Asia–Pacific region define extent of problem and get prepared to handle impending epidemic of CD.
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