From the Guidelines
Celiac disease can develop at any age, from infancy through late adulthood. While many people are diagnosed as children when they begin eating gluten-containing foods, it's increasingly common for celiac disease to be diagnosed in adults, even in their 60s, 70s, or beyond 1. The disease requires genetic predisposition, but symptoms may not appear until triggered by factors such as stress, pregnancy, surgery, viral infections, or changes in gut bacteria. This explains why some people develop symptoms later in life despite having the genetic susceptibility since birth.
Key Points to Consider
- The disease involves an autoimmune reaction where the body's immune system attacks the small intestine when gluten is consumed.
- For diagnosis, individuals should not eliminate gluten from their diet before testing, as this can affect test results 1.
- Testing typically includes blood tests for specific antibodies and may require intestinal biopsy for confirmation.
- Once diagnosed, the only effective treatment is a strict, lifelong gluten-free diet.
Important Considerations for Diagnosis and Management
- Patients with symptoms, signs, or laboratory evidence of malabsorption should be tested for celiac disease 1.
- Dietary non-adherence in adolescents is associated with increased disease burden, poorer quality of life, and increased physical symptoms 1.
- The cost of gluten-free products is often substantially higher than that of gluten-containing products, which can impact dietary adherence, especially in young adults 1.
From the Research
Age of Onset for Celiac Disease
- Celiac disease can develop at any age, as stated in studies 2, 3, 4.
- The age of onset ranges from infancy to old age, according to 3.
- Most common period of presentation is between six months and two years of age, as mentioned in 5.
- However, it's also possible for celiac disease to be diagnosed in adulthood, as seen in the 28-year follow-up study 6, where the mean age of the group was 35 years.
Key Points
- Celiac disease is an autoimmune disorder that can affect people of all ages.
- The condition is triggered by exposure to dietary gluten in genetically susceptible individuals.
- Symptoms can vary widely, including intestinal manifestations like diarrhea and weight loss, as well as extraintestinal manifestations such as iron deficiency anemia and neuropathy.
- Diagnosis is typically supported by a positive tissue transglutaminase serologic test and confirmed by a small bowel biopsy, as noted in 2.