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Are celiac disease symptoms going silent over the years?

Posted:  Tuesday, December 09, 2014

Just 15 years ago, celiac disease was considered as a rare paediatric food intolerance most commonly typified by diarrhoea and intestinal damage. However, Italian scientists in their recent study have found that those suffering from this intestinal condition no longer show the classical symptoms and instead display atypical and silent manifestations.

Published in the journal BMC Gastroenterology, the study involved 770 patients, 599 of them females diagnosed between 1998 and 2007. Nearly half the patients were diagnosed during the first 10 years of the study and the rest in the last five years, indicating a steep rise in the rates of diagnosis.

Among the patients, 79% of them had presented with atypical symptoms like bloating, osteoporosis, and anaemia at the time of diagnosis, whereas only 27% of them had presented with diarrhoea. The researchers noted a reduction in the classical symptoms from 47% patients during the first 10 years to 13% in the last five. On the other hand, the presentation of other symptoms increased by more than 86%. The most common illness associated with celiac was thyroid disease. Only half the patients had severe intestinal damage.

"The most striking change in clinical presentation of celiac disease over time has been the decrease of diarrhoea as the leading symptom and the progressive increase of other non-classical gastrointestinal symptoms,” said the lead researcher Umberto Volta. He added, "A high proportion of celiac disease patients did not show any gastrointestinal symptom, but they displayed extra-intestinal manifestations such as iron-deficiency anaemia, unexplained osteoporosis, abnormalities of liver-function tests and recurrent miscarriages."

This change in the symptom profile could be due to early diagnosis of celiac disease-related antibodies with blood tests, believe the scientists. Celiac disease is the most common form of food intolerance seen in adults and children. As the symptoms of celiac disease go silent, the team of scientists suggest looking out for other atypical symptoms to diagnose the condition.

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