Celiac Disease (cont.)
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 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 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 can 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 only one, or only a
few signs of malnutrition such as iron deficiency anemia, abnormal
bleeding, or bone fractures. Some patients with celiac disease and
gastrointestinal symptoms are mistakenly diagnosed with
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 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.
Next: What is latent and silent celiac disease? »
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