title: The unknown burden and cost of celiac disease in the U.S.
abstract: 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.
authors.affiliation: a Department of Pediatrics , Johns Hopkins University School of Medicine , Baltimore , MD , USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Mogul
authors.affiliation: b Department of Health Policy and Management , Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: b Department of Health Policy and Management , Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA.
authors.forename: Jaein
authors.initials: J
authors.lastname: Seo
authors.affiliation: c Institute for Global Health , University of Massachusetts , Amherst , MA , USA.
authors.forename: Barri
authors.initials: B
authors.lastname: Blauvelt
authors.affiliation: b Department of Health Policy and Management , Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA.
authors.forename: John F P
authors.initials: JF
authors.lastname: Bridges
mesh_terms: D002446:Celiac Disease / Q000178:diet therapy / Q000191:economics* / Q000453:epidemiology; D017281:Cost of Illness; D055050:Diet, Gluten-Free; D020022:Genetic Predisposition to Disease; D005983:Glutens / Q000009:adverse effects; D006801:Humans; D011788:Quality of Life; D014481:United States / Q000453:epidemiology
chemical_list: D005983:Glutens
keywords: Celiac disease; burden of disease; cost of illness; gluten; quality of life