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- Most People Diagnosed With Celiac Disease Show No Symptoms
Most People Diagnosed With Celiac Disease Show No Symptoms
- By Jefferson Adams
- Published 02/18/2008
- Celiac Disease Diagnosis, Testing & Treatment (Gluten-Free Diet)
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Jefferson Adams
Jefferson Adams is a freelance writer living in San Francisco. His poems and essays have appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, and The Mississippi Review, among others.
View all articles by Jefferson AdamsMost People Diagnosed With Celiac Disease Show No Symptoms
Celiac.com 02/18/2008 - A greater awareness of celiac disease, coupled with better and more accurate tests for celiac disease have helped to bring about a situation where most people currently diagnosed with celiac disease show no symptoms at the time of their diagnosis. Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. This finding has caused doctors to call for an adjustment to screening procedures for high-risk populations.
A team of researchers led by Dr. Grzegorz Telega recently surveyed medical records of people diagnosed with celiac disease at Children's Hospital of Wisconsin from 1986 to 2003. The statistics showed that the number of celiac disease diagnosis rose from a single case in 1986 to 93 cases in 2003. The total number of cases during that period was 143.
Before the mid-1990’s, more than 85% of children diagnosed with celiac disease were under 10 years old, with the average age being just over 5 years old. After 1995, less than 50% of children diagnosed with celiac disease were under 10 years old, and the average age at diagnosis had risen to about 8.5 years of age. Children diagnosed before the age of 3 years old usually complained of classic celiac-associated gastrointestinal symptoms, such as malnutrition, diarrhea, abdominal pain, and bloating, while children diagnosed at older ages had less pronounced symptoms.
One of the important conclusions made by the research group is that the possibility of celiac disease should be strongly considered in people with other autoimmune disorders, even if those people do not show gastrointestinal symptoms traditionally associated with celiac disease.
The research team called upon primary care doctors to adopt a practice of celiac screening for all people with elevated risk factors, including people with a family history of celiac disease, people with Addison’s disease Down Syndrome type 1 diabetes, thyroiditis, Turner syndrome, and type 1 diabetes. The team also called for screening of patients with short stature, iron deficiency anemia, and high transaminase levels.
Arch Pediatr Adolesc Med 2008;162:164-168.
A team of researchers led by Dr. Grzegorz Telega recently surveyed medical records of people diagnosed with celiac disease at Children's Hospital of Wisconsin from 1986 to 2003. The statistics showed that the number of celiac disease diagnosis rose from a single case in 1986 to 93 cases in 2003. The total number of cases during that period was 143.
Before the mid-1990’s, more than 85% of children diagnosed with celiac disease were under 10 years old, with the average age being just over 5 years old. After 1995, less than 50% of children diagnosed with celiac disease were under 10 years old, and the average age at diagnosis had risen to about 8.5 years of age. Children diagnosed before the age of 3 years old usually complained of classic celiac-associated gastrointestinal symptoms, such as malnutrition, diarrhea, abdominal pain, and bloating, while children diagnosed at older ages had less pronounced symptoms.
One of the important conclusions made by the research group is that the possibility of celiac disease should be strongly considered in people with other autoimmune disorders, even if those people do not show gastrointestinal symptoms traditionally associated with celiac disease.
The research team called upon primary care doctors to adopt a practice of celiac screening for all people with elevated risk factors, including people with a family history of celiac disease, people with Addison’s disease Down Syndrome type 1 diabetes, thyroiditis, Turner syndrome, and type 1 diabetes. The team also called for screening of patients with short stature, iron deficiency anemia, and high transaminase levels.
Arch Pediatr Adolesc Med 2008;162:164-168.
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Comments
#1 ( Barbara Poole)
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I think Doctors need to be educated on the fact that not all celiacs show symptoms. My Son recently asked his Dr. for the blood test but the Dr. refused as he didn't show any symptoms. However as his Mother (with Celiac) I strongly suspect he may have it.
#2 ( Bob Morello)
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Found the article very informative, since I was diagnosed with Celiac just over 16 months ago. Although, I've probably had the problem for at least four-and-a-half years. That is when I developed a rash that included bubbles filled with what appeared to be water. These appeared mostly on my elbows, knees, and other parts of my body. For 3 solid years, I went to a local well-known Dermatologists office. My problem was never diagnosed, I was told it could be exzema, or some other such rash. A biopsy was done which I was told was 'inconclusive'. At time my doctor moved out of state and was replaced by another female doctor. I opted to see this new doctor. On my first visit with her she looked at the rash which at this time now appeared on my elbows. She asked if I would mind if she did a biopsy. I reminded her that I had just a biopsy, and she said that she was aware of that, but wished to do a second biopsy. She called me with the results and said that I had a case of Dermatitis Herpetaformis. I immediately research DH and read about its association with Celiac. She suggested that I go for a blood test to see if Celiac was detected. I then was told that the results pointed strongly to Celiac, and that the Gold Standard was the Endoscopy. After the Endoscopy, the doctor told me that I indeed had Celiac. I don't ever remember having any Celiac-related symptoms, and was totally shocked. I have since gone on a zero-tolerance Gluten-Free diet, and immediately dropped 24 pounds, not a good way to lose weight. I have since put back on about six pounds, and feel good, but still have problems finding stuff to eat that will make me happy. I hated giving up pizza, and I was a big fan of Italian pastry, and while it has eased the pain a bit, I'd really like to know if I will ever be able to eat pizza or pastry again, even if not reverting to a 'normal' diet again. I'd like to hear some input from other readers. Is there a time that I can get tested to find out if I am healing (or will ever heal). Thanks.
#3 ( Dr. Stephen Wangen)
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There really is no good medical reason not to do a blood test for celiac disease, especially with a family history of celiac disease or gluten intolerance. If doctors really wanted to do true preventive medicine, then we would be screening people for this condition long before they ever developed obvious symptoms. And of course, the list of potential signs and symptoms is very long. If your doctor won't run the test, then you should find someone who will.
#4 ( Laura Hicken)
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I had Celiac disease for over a year and a half before it was diagnosed even though I had very classic symptoms. I was placed on a whole wheat diet and went through a litany of tests before I was finally diagnosed. My doctors claimed they didn't test for it because such a small percentage of the population has it that they thought it was unlikely. It was only after my diagnosis that I started to realize that other problems I had when I was younger (joint pain, poor circulation, gastrointestinal discomfort and cramping and low iron levels) were probably early indicators. The symptoms can be so broad and subtle that I think it's unfortunate that doctors don't test for it more readily and more often. I feel lucky that I was diagnosed as early as I was.
#5 ( Sherry-Ann Herman-Kalpoo)
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I think that the blood test should be done at some point in your life even though you do not have any symptoms. I do not think that I have celiac disease but would like to get tested, because my baby was just six months old when she started having severe diarrhea. For three months I visited doctors in my country Trinidad and they could not find anything wrong with her. She started loosing weight rapidly from 12 lbs. she went to 9 lbs. in just a matter of a week , she started getting life less. Finally I asked my doctor to get me a recommendation to visit Miami Children's Hospital where we visited DR. Jesse Revees Garcia a gastroenterologist and he did a biopsy and a endoscopy and my baby was diagnosed with celiac disease even though neither my husband or my self does not have any symptoms associated with celiac disease.
#6 ( Lynch)
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I was just wondering it anyone knew the consequences of not following a gluten free diet if you've been positively diagnosed, but show no symptoms.
Please consider the people who show no difference in attitude or fecal excretion on or off the diet, but have been given the 100% positive diagnosis more than once.
If you show no visible difference on or off the diet, then is it necessary to go on a gluten free diet?
If so many people show no symptoms and are never diagnosed, then it is possible you could've potentially gone your whole life without knowing, and remained happy eating chewy 2$ loaves of bread and takeout pizza.
Sure by not going on a gluten free diet, you've increased your risk of some diseases, but by how much? And don't a lot of things increase our risk of dying? What happens if you go on a gluten free diet and get osteoporosis anyways? I'd be pretty bitter that I said no to my grandmother's homemade birthday cake just because I was on a diet that turned out to make little difference in my health except make my life a whole lot more miserable.
#7 ( kay ashburn)
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I found this to be very informative and it also helped me to feel a little more connected. I sometimes feel so alone with this disease. Thank you again.
#8 ( Tichy)
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Five stars. Lynch's comment gets the boot; that denial stage is a bugger! For all in denial: You are in control of your health. Are you as healthy and happy as you can be? It seems that some people need the threat of cancer looming over them in order to comply with a gluten-free diet. Well - you have it - intestinal lymphoma is a real possibility in untreated sprue. REFERENCE: Intestinal lymphoma and sprue: A systematic approach
Dutz et al. Gut.1971; 12: 804-810.
#9 ( mimi)
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I'm in denial..I've been watching seriously now for 9 months and today I ate a chocolate chip cookie...it was just looking at me and now I'm suffering...my stomach is talking, my back is killing me, I have to go lay down, my head hurts, I'm just a mess... so this last fling...is over...why do I do this?
#10 ( vicky)
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I think this is a good article but I wish someone would talk more about those without NO symptoms. it is so hard for us. yes, I'm glad I don't get sick, but I never know if I am accidentally taking in gluten (I have been gluten-free for almost a year) and it makes me doubt my positive celiac disease diagnosis. I am strongly considering doing the gluten challenge for this reason. I never had a biopsy and think maybe I should do it just in case. But I know all about the complications with the gluten challenge, and I'd hate to have done that to myself (getting back on gluten ... yuck!) and then not get an accurate result. so stressed!
#11 ( charlotte)
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I have been on the gluten free diet for 5 1/2 weeks now and been told I have celiac disease. I have never been tested to find out for sure if I have it. I was in the hospital and my medical Doctor just assumes I have it.
I did the gluten challenge and I know I am gluten free.
Also another one of my doctors wants me to have a test to find out if I am indeed celiac, so I agreed to be tested. That should be soon. I'm sure I am though...