Report: Celiac Disease Widely Under Diagnosed

A new study published in JAMA Pediatrics suggests that physicians should become “suspicious” when it comes to a vastly under diagnosed disorder: celiac disease.

According to the report, only 15% of those who have celiac disease have actually been diagnosed, yet the food allergy that causes the disease, an allergic reaction to gluten, is the most common; it’s estimated that 1% of the global population has the allergy, which can only be managed with a gluten free diet.  That’s the bad news. The good news is that all symptoms go away if a patient follows a strict GFD.

Why are 85% of those afflicted with the disorder undiagnosed? Because of two misconceptions about the disease:

  1. That it only presents in young children and adolescents
  2. That gastrointestinal problems are the only symptoms associated with the disease

The gastrointestinal misconception is understandable, as celiac disease is a disorder in the lower intestine. But more and more, doctors are realizing that the disease can present in through a wide array of symptoms; in fact, there are many who have the disease who have no gastrointestinal issues at all.

As far as the first misconception goes, researchers have discovered that the disease can first present at any age, even among the elderly.

According to the report, the following are typical gastrointestinal symptoms of the disease:

  • Diarrhea
  • Anorexia
  • Vomiting
  • Failure to thrive or weight loss
  • Abdominal pain, bloating
  • Constipation

However, as stated previously, not everyone afflicted has these symptoms, hence the directive that physicians be “suspicious” that celiac disease may be the culprit in some of their patient cases, especially if those patients present with the following non-gastrointestinal symptoms of the disease:

  • Fatigue
  • Iron deficiency anemia
  • Dermatitis herpetiformis (red, blistery rash)
  • Dental enamel hypoplasia
  • Ulcers in the mouth
  • Arthritis
  • Arthralgia
  • Osteoporosis
  • Fractures
  • Short stature
  • Delayed puberty
  • Unexplained infertility in women
  • Miscarriage
  • Recurring headaches
  • Peripheral neuropathy
  • Seizures

Additionally, the disease can present as psychiatric disorders (anxiety, panic attacks, depression), especially in adolescents.

Although the disease is complex re symptomotology, once it’s suspected, it is relatively easy to diagnose through blood work.

The Mayo clinic has more information on maintaining a gluten free diet if you’ve been diagnosed with celiac disease.

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