Celiac disease history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Celiac disease may present with typical symptoms such as diarrhea, steatorrhea, weight loss, and growth failure or non-typical symptoms not involving the gastrointestinal tract. The classic presentation of celiac disease is more common in young children, consisting primarily of gastrointestinal symptoms. In adults, the presentation of celiac disease is often more subtle and can be mistaken for irritable bowel syndrome. Some patients lack any evident gastrointestinal symptoms and instead present with nutritional deficiencies (most commonly iron deficiency) or extra-intestinal symptoms, or are asymptomatic.
History
A detailed and thorough history from the patient is necessary. It provides insight into the cause, precipitating factors and associated comorbid conditions. Specific areas of focus when obtaining a history from the patient with celiac disease include:[1]
- Unexplained gastrointestinal symptoms
- Chronic diarrhea
- Symptoms of fatigue and tiredness (iron deficiency anemia)
- Skin rash consistent with dermatitis herpetiformis
- Family history of celiac disease and inflammatory bowel disease
Symptoms
Celiac disease may present with typical symptoms such as diarrhea, steatorrhea, weight loss, and growth failure or non-typical symptoms involving extra-intestinal manifestations. The classic presentation of celiac disease is more common in young children, consisting primarily of gastrointestinal symptoms. In adults, the presentation of celiac disease is often more subtle and can be mistaken for irritable bowel syndrome. Some patients lack any evident gastrointestinal symptoms and instead present with nutritional deficiencies (most commonly iron deficiency) or extra-intestinal symptoms, or are asymptomatic.
The following table summarizes the symptoms of celiac disease in adults.[2][3][4][5][6][7]
| Symptoms frequency | Symptoms | |||||||
|---|---|---|---|---|---|---|---|---|
| Intestinal | Extra-intestinal | |||||||
| Hematologic | Dermatologic | Neurologic | Musculoskeletal | Hepatic | Renal | Cardiac | ||
| Common
Symptoms |
- | - | ||||||
| Less common
symptoms |
|
|
||||||
In children gastrointestinal symptoms predominate than extra-intestinal symptoms in celiac disease. Symptoms include:[8][9][10]
Common symptoms of celiac disease in children
Less common symptoms of celiac disease in children
- Anorexia
- Abdominal distention
- Vomiting
- Bloating
- Growth failure
- Irritability
- Fatigue
- Irregular bowel habits
References
- ↑ Green PH, Cellier C (2007). "Celiac disease". N. Engl. J. Med. 357 (17): 1731–43. doi:10.1056/NEJMra071600. PMID 17960014.
- ↑ Zipser RD, Patel S, Yahya KZ, Baisch DW, Monarch E (2003). "Presentations of adult celiac disease in a nationwide patient support group". Dig. Dis. Sci. 48 (4): 761–4. PMID 12741468.
- ↑ Lasa JS, Zubiaurre I, Soifer LO (2014). "Risk of infertility in patients with celiac disease: a meta-analysis of observational studies". Arq Gastroenterol. 51 (2): 144–50. PMID 25003268.
- ↑ Freeman HJ (2008). "Neurological disorders in adult celiac disease". Can. J. Gastroenterol. 22 (11): 909–11. PMC 2661192. PMID 19018335.
- ↑ Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, Mulder CJ, van Bodegraven AA (2013). "Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients". Nutrients. 5 (10): 3975–92. doi:10.3390/nu5103975. PMC 3820055. PMID 24084055.
- ↑ Casella G, Antonelli E, Di Bella C, Villanacci V, Fanini L, Baldini V, Bassotti G (2013). "Prevalence and causes of abnormal liver function in patients with coeliac disease". Liver Int. 33 (7): 1128–31. doi:10.1111/liv.12178. PMID 23601438.
- ↑ Troncone R, Discepolo V (2014). "Celiac disease and autoimmunity". J. Pediatr. Gastroenterol. Nutr. 59 Suppl 1: S9–S11. doi:10.1097/01.mpg.0000450394.30780.ea. PMID 24979198.
- ↑ Bottaro G, Failla P, Rotolo N, Sanfilippo G, Azzaro F, Spina M, Patane R (1993). "Changes in coeliac disease behaviour over the years". Acta Paediatr. 82 (6–7): 566–8. PMID 8338991.
- ↑ Rashid M, Cranney A, Zarkadas M, Graham ID, Switzer C, Case S, Molloy M, Warren RE, Burrows V, Butzner JD (2005). "Celiac disease: evaluation of the diagnosis and dietary compliance in Canadian children". Pediatrics. 116 (6): e754–9. doi:10.1542/peds.2005-0904. PMID 16322131.
- ↑ van Rijn JC, Grote FK, Oostdijk W, Wit JM (2004). "Short stature and the probability of coeliac disease, in the absence of gastrointestinal symptoms". Arch. Dis. Child. 89 (9): 882–3. doi:10.1136/adc.2004.057851. PMC 1763207. PMID 15321874.