Clinical presentation of Celiac disease has changed over the time
Celiac disease is a rare pediatric disease associated with food intolerance. The most common symptoms are pain in abdomen and diarrhea. The disease is associated with intestinal damage which can easily be identified during a biopsy. However, if we go by a new study carried out by Dr. Umberto Volta and his associates and published in the journal BMC Gastroenterology, this was the scenario around 15 years back.
In recent years, celiac disease has evolved so much that it will be difficult to recognize it by its classical symptoms. More commonly observed nowadays are the non-classical gastrointestinal symptoms like constipation, alternate bowel habits, bloating, gastro-esophageal reflux, dyspepsia, nausea and vomiting. Extra-intestinal manifestations like iron deficiency anemia, migraine, unexplained osteoporosis, deranged liver functions and frequent miscarriages have also become exceedingly common.
For their study, the researchers examined 770 patients out of which 599 were females. All these cases had been diagnosed with celiac disease in between 1998 and 2007. Almost 50% of these cases were diagnosed in the latter half of the study period indicating a rapid improvement in the rate of diagnosis. 79% of these patients had symptoms when they were first diagnosed. But most of them presented with the non-classical gastrointestinal or extra-intestinal symptoms. Only 27% of the patients presented with the classical diarrhea symptom.
According to the experts, classical symptoms of celiac disease have been progressively diminishing over the course of time. Even in the study subjects, while 47% patients exhibited classical symptoms in the first 10 years of the study period, only 13% exhibited the classical symptoms during the last 5 years of the study. On the other hand, non-classical symptoms rose by almost 86%.
Thyroid disease is frequently found associated with celiac disease. Only 50% of the patients had severe intestinal damage. Researchers noted that unlike before, when biopsy was essential to establish the diagnosis of celiac disease, nowadays, a simple blood test to identify specific antibodies associated with the disease has considerably simplified the diagnosis. If the physicians are aware of the non-classical symptoms of the disease, a diagnosis can be made before extensive damage to the intestine takes place.