Celiac Disease (cont.)
Bhupinder Anand, MD
In this Article
How do symptoms of celiac disease differ with age of onset?
In the past, celiac disease was considered to be a disease primarily of infants and children. It is now clear that the initial signs and symptoms of celiac disease can occur in adults and even in the elderly.
Symptoms in infants
Infants with celiac disease typically have diarrhea, steatorrhea, abdominal cramps, abdominal distension, irritability, muscle wasting, and failure to thrive and grow. These symptoms typically occur after the introduction of gluten-containing cereals into their diets.
Symptoms in children
Children with celiac disease typically have diarrhea, increased amounts of fat in the stool (steatorrhea), flatulence (passing gas), short stature and weight loss. Proper treatment with a gluten-free diet can lead to accelerated (catch-up) growth in height; however, if untreated, childhood celiac disease can result in short stature as an adult. As children with celiac disease enter adolescence, many will experience spontaneous remissions (reduced symptoms) and remain free of the signs and symptoms of celiac disease until later in adulthood. This later reactivation may be precipitated by stress such as pregnancy or surgery.
Symptoms in adults
Adults with celiac disease may have symptoms of diarrhea, steatorrhea, weight loss and flatulence; however, many adults do not have diarrhea or steatorrhea. They have either no symptoms or only vague abdominal discomfort such as bloating, abdominal distension and excess gas. They also may have one, or only a few signs of malnutrition such as iron deficiency anemia, abnormal bleeding (a sign of vitamin K deficiency), or bone fractures (due to deficiencies of calcium and/or vitamin D). Some individuals with celiac disease and gastrointestinal symptoms are mistakenly diagnosed to have irritable bowel syndrome (IBS).
There have been changes during the past 20 years in the way in which celiac disease is diagnosed. The average age at which celiac disease is diagnosed has increased, probably because of the increased awareness that the disease can first cause symptoms or signs in adults. Whereas in the past, diarrhea was the initial symptom in 80% of patients, it now is the initial symptom in only 40%. A small proportion of patients -- about 15% -- are now diagnosed with blood antibody tests because they have a close relative with celiac disease, and they are being screened to see if they also have the disease.
Reviewed by Bhupinder Anand, MD on 8/12/2013
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