The Different Types of Celiac Disease

Celiac.com 11/11/2022 - You are either diagnosed with celiac disease, are gluten sensitive, or perhaps you have latent or silent celiac disease, which may mean that you seem to have few or even no health problems at all, yet you sill are a celiac. Latent and silent celiac disease seem to occur more often in adults, but they can also affect children as well. Did you know that there are several types of celiac disease, and experts don't always agree on how to deal with each type?

Researchers Now Recognize Several Types of Celiac Disease:

Classic Celiac Disease

This version manifests with the classical GI symptoms of abdominal pain, diarrhea, nausea, and possible vomiting, which can also cause dehydration, dizziness, and lead to vitamin and mineral deficiencies. This type of celiac disease is usually the easiest form to diagnose. People in this category will end up having positive blood antibody and endoscopy (biopsy) test results for celiac disease, and all doctors should recommend that they go on a gluten-free diet for life.

Atypical Celiac Disease

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People with atypical celiac disease generally do not have GI symptoms, but they may have other health issues, for example autoimmune thyroid problems, unexplained skin rashes, undefined bleeding, and/or nerve damage like ataxia. Those with this form of celiac disease can often go undiagnosed for years, and many have to go from doctor to doctor before they finally get the proper tests done and get diagnosed. Those in this category will end up having positive blood antibody and endoscopy (biopsy) test results for celiac disease, and all doctors should recommend that they go on a gluten-free diet for life.

Asymptomatic Celiac Disease or Silent Celiac Disease

This category is also a form of atypical celiac disease, and it is categorized by those who have little or no symptoms, but it can still affect different parts of their body. Since celiac disease, in any form is a skin, gut, and brain/nerve disease, it can often be difficult to diagnose silent or asymptomatic celiac disease, and it is often found by accident while running other medical tests. Some may have abnormal liver tests, or low iron and/or B12 or other nutrient levels, and even though they may not have any symptoms they will still have various levels of villous atrophy of the small intestines. Many in this group are sent to numerous specialists, and end up having many medical tests done before discovering that they have celiac disease. Those in this group will end up having positive blood antibody and endoscopy (biopsy) test results for celiac disease, and all doctors should recommend that they go on a gluten-free diet for life.

Silent or asymptomatic celiac disease tends to be the most difficult form of celiac disease to diagnose, and many in this category are totally surprised at the time of their diagnosis, and can often be skeptical about needing to go on a gluten-free diet. A minority of doctors may even tell silent celiac disease patients that a gluten-free diet is optional, however, all patients in this group should go gluten-free.

Potential Celiac Disease or Latent Celiac Disease

People in either of these groups may have positive blood tests for celiac disease yet a negative biopsy. Some experts believe that this may be an early stage of celiac disease, before the villi are damaged. Some doctors tell patients in this group that they do not need to be on a gluten-free diet, however, anyone who has abnormally high celiac disease antibody levels likely falls into the “non-celiac gluten sensitivity” (NCGS) category, and many experts agree that this could represent a pre-celiac disease stage, and if so it would be best to avoid uncomfortable symptoms and other possible related health issues, so people in this group should also consider going on a gluten-free diet for life.

I used to feel very sorry for the atypical and silent celiac disease folks, but I stopped feeling so sorry for them because they usually don't have dermatitis herpetiformis, which I have, and my dermatitis herpetiformis symptoms can be horrible. While the some people in the asymptomatic or silent category may not want to go gluten-free, even though they should, I knew within twenty-four hours that I had been "bitten" with gluten because my dermatitis herpetiformis sores would itch and drive me crazy, but at least I knew I had ingested gluten. Whenever this happens I'm in for a tough itchy time for a ten day period, and need to use Dapsone for the itch and Atarax to help eliminate me continually scratching my scalp, arms and thighs. 

A big warning to those with potential celiac disease and latent celiac disease: If you continue ingesting gluten, one day you may be surprised that you have graduated to the classic form of celiac disease and end up with malabsorption issues and a host of related health issues, perhaps even dermatitis herpetiformis. Again, many experts agree that patients in these groups should remain gluten-free, which may help some to escape getting full blown celiac disease, while allowing others to avoid the many issues that can be associated with non-celiac gluten sensitivity.