Celiac Disease Didn’t Exist When I Was a Kid!

I often hear people erroneously making statements about how problems like celiac disease, food allergies, autism and other issues are modern day problems. This sentiment is then followed by claims that these problems didn’t exist some random amount of years ago. The implication being that they are modern day constructs, rather than true medical diagnoses. 

I am here to dispute these claims about celiac disease, to provide information on the history of celiac disease, and to discuss the origins of the gluten free diet. I can say without hesitation that celiac disease absolutely, 100% has existed for over a hundred years. 

The history of celiac disease is fascinating because it actually goes back thousands of years!


Celiac Disease in The First Century A.D.

Researchers identified evidence of celiac disease (CD) in a skeleton dating back to the first century AD, demonstrating that the condition is not a modern creation. The team of scientists carried out their groundbreaking research on a young woman’s remains (age 18-20) discovered in the archaeological dig site of Cosa, Italy.

The female skeleton showed clear signs of malnutrition, such as short stature, osteoporosis, dental enamel hypoplasia (a marker of nutritional or infectious stress), and cribra orbitalia (a bone porosity usually linked to anemia).

Researchers considered if these symptoms could be caused by a lack of food, but the theory was excluded because her jewelry, tomb and other signs indicated she was probably from a wealthy family. It was inferred that the woman did not starve due to a lack of available resources, but rather suffered from a health condition that prevented her body from absorbing nutrients. These symptoms are synonymous with known celiac disease symptoms.

However, the physical signs and symptoms aren’t enough to conclusively prove the woman suffered from CD. Therefore, the researchers turned to genetic analysis for further evidence. Genetic susceptibility plays a critical role in the development of CD. Celiac patients express a specific human leukocyte antigen (HLA), which means the absence of these genetic markers almost certainly rule out a diagnosis of CD.

You can check out the study here to learn the details about how DNA was extracted and the precautions taken to ensure the authenticity of the results.

The results showed that the young woman displayed HLA DQ 2.5, a haplotype associated with the highest risk of celiac disease. This provides compelling molecular evidence supporting the hypothesis that the woman suffered from CD, reinforcing the physical symptoms found on her skeleton. Researcher hypothesize that the woman had celiac disease and died from severe malnutrition, or from a complication of malnutrition.


The Ancient History of Celiac Disease

One key figure in our understanding of this disease is the ancient physician Aretaeus of Cappadocia, who lived in the first century AD. Aretaeus studied medicine in Alexandria, Egypt, before serving as a physician in Rome.

It’s difficult to talk about the history of celiac disease without discussing Aretaeus’ contributions. Currently, we owe a great deal to Aretaeus of Cappadocia, whose ancient observations continue to be relevant in contemporary medical discourse.

Aretaeus followed the method of Hippocrates and is best known for his contributions to medical literature. He was detailed, insightful and wrote in depth about different diseases, their symptoms and treatments. In fact, some of his observations directly shaped our modern day understand of celiac disease.

Without having any knowledge or awareness of autoimmune conditions, Aretaeus wrote about the distinctive symptoms of celiac disease. In his eight-volume medical text “On the Causes and Symptoms of Acute Disease,” Aretaeus provided a remarkably accurate description of celiac disease, identifying its characteristic gastrointestinal distress and nutrient malabsorption.

Another reason we can’t discuss the history of celiac disease without Aretaeus is because of his coining the term coeliacs.

Arataeus wrote “If the stomach be irretentive of the food and if it pass through undigested and crude, and nothing ascends into the body, we call such persons coeliacs.” 

Here, he used the term “coeliacs,” derived from the Greek word “koiliakos,” meaning “suffering in the bowels.”

His writings lay the foundation for our current understanding of celiac disease, solidifying his legacy as 

Aretaeus is one of the early pioneers in the study of celiac disease because his writings lay the foundation for our current understanding of this condition and many others. In fact, modern day research studies still cite the works of Aretaeus.


The Modern Era of Celiac Disease

Matthew Baillie was a Scottish physician, pathologist and a well known anatomist. He made significant strides in advancing our understanding of celiac disease. In 1793, Baillie published his book, “Morbid Anatomy of the Human Body”, in which he described a chronic malabsorptive disorder resulting in diarrhea and weight loss. Baillie based this on detailed observations and patient dissections. 


Although Baillie’s description was not officially identified as celiac disease at the time, his work signified one of the earliest attempts to categorize diseases through pathology rather than mere symptom observation.

Another important figure in celiac disease history is the British physician, Dr. Samuel Gee. Influenced by the works of Aretaeus and drawing from his own clinical experiences, Gee hypothesized a distinct cause of celiac disease and emphasized the connection between diet and symptom improvement.

His assertion “if the patient can be cured at all, it must be by means of diet.” marked a significant leap in understanding and managing celiac disease.


The Banana Diet

Dr. Sidney Valentine Haas, an American pediatrician, played a significant role in understanding celiac disease during the early 20th century. Hass created the banana diet and advanced the history of celiac disease before any connection with gluten was even known. 

Haas based his banana diet treatment on the belief that certain complex carbohydrates were causing celiac symptoms. His approach involved removing starchy foods like bread and cereals from the patients’ diet and using bananas as the main source of calories. 

Surprisingly, the diet led to a significant improvement in the health of his patients. In fact, It was the standard treatment for celiac disease until the 1950’s, when gluten was finally connected to the condition.

Dr. Haas’ work was an important part of celiac disease history because he demonstrated that diet could decrease celiac disease’s symptoms. 


WWII and Celiac Disease

A tragic period during World War II led to a crucial discovery in the history of celiac disease. The Hunger Winter, also called the Dutch famine of 1944-1945, led to the Netherlands being cut off from food supplies. This caused a serious shortage of basic necessities, including bread. 

During this time, Dutch pediatrician Dr. Willem Dicke observed a shocking phenomenon — his patients with celiac disease showed significant improvement in their health condition, even though they were being starved. While everyone else suffered the debilitating effects of starvation, the children with celiac disease seemed to get better. Their debilitating digestive symptoms seemed to abate.

When bread products were finally delivered via airdrop and consequently reintroduced into the children’s diets, the celiac symptoms came back. Dr. Willem Dicke’s observations paved the way for a groundbreaking hypothesis: could the cause of celiac disease be related to diet, specifically to something in bread?

After the war, Dr. Dicke’s continued this line of research and confirmed this theory. He conclusively linked the protein gluten, found in wheat and other grains, to the onset of celiac disease. His discovery was instrumental in the eventual development of the treatment plan that still holds today — a strict, lifelong gluten-free diet.


Advancement of the Celiac Disease Diagnosis

Dr. Margot Shiner, a British gastroenterologist, significantly advanced the ability to diagnose celiac disease. In the mid-20th century her innovative invention, the Crosby-Shiner capsule, transformed the way doctors could obtain biopsies from the small intestine. This eliminated the need for invasive surgery!

By enabling medical professionals to easily access and examine tissue samples from the small intestine, the Crosby-Shiner capsule led to a more accurate diagnosis of celiac disease. Through her inventive contribution, Dr. Shiner revolutionized the understanding and diagnosis of celiac disease, leaving a lasting impact on gastroenterology and the history of celiac disease as a whole.