Common Presentation of Adult Celiac Disease in the United States
Project Type
Event
Location
Alvin Sherman Library 1054
Start Date
19-4-2002 12:00 AM
End Date
19-4-2002 12:00 AM
COinS
Apr 19th, 12:00 AM
Apr 19th, 12:00 AM
Common Presentation of Adult Celiac Disease in the United States
Alvin Sherman Library 1054
OBJECTIVES: Epidemiological studies primarily from Europe document that adult celiac disease is common and frequently lacks the classic childhood presentation of steatorrhea, weight loss and failure to thrive. However, adult celiac disease is not commonly diagnosed in the United States. Untreated celiac disease may impair quality and duration of life. We sought to foster physician awareness of adult celiac disease by providing survey data.
Comments
METHODS: Questionnaires of demographic and diagnostic data were sought from members of a patient support group from 1993 to 2001 (n=1032). A detailed description of adult presenting symptoms was also obtained via Internet e-mail (n=134). All had diagnosis confirmed by small bowel biopsy.
RESULTS: At diagnosis, median age was 46 years and only 12% were less than 10 years old. In adults 32% were underweight (body mass index = 18.5) and 14% overweight (BMI = 25). Physician diagnosis was often delayed (median 12 months) with 21% over 10 years. Frequent presentations were non-specific: fatigue (82%), abdominal pain (77%), bloating or gas (73%), and anemia (63%). Weight loss was reported in 55%, but 21% had weight gain. Diarrhea was common in 52%, but 31% reported constipation or both. Frequent initial diagnoses were irritable bowel syndrome (37%), psychological disorders (29%) and fibromyalgia (19%).
CONCLUSION: In the United States, celiac disease presents primarily in adulthood with non-specific symptoms frequently mimicking irritable bowel syndrome or psychological disorders. The lack of classic childhood symptoms may account for the under-recognized and delayed diagnoses.