Patients are receiving initial diagnosis of celiac disease at an older age

Patients are receiving initial diagnosis of celiac disease at an older age and with a shorter duration of symptoms, according to a retrospective study presented today at the 69th Annual Scientific Meeting of the American College of Gastroenterology.

Findings are based on evaluations of patients from 1952 to 2004 who had celiac disease, a condition where patients cannot tolerate gluten, a protein in foods containing wheat, rye and barley.

This study looked at a large group of 590 patients with a diagnosis of celiac disease established by biopsy. Researchers grouped patients based on year of diagnosis and compared over time trends in age at diagnosis, duration of symptoms, mode of presentation including whether they presented with symptoms such as diarrhea, anemia or bone disease or whether the condition was diagnosed through screening. Researchers also looked for presence of malignancy.

There was a highly significant negative linear trend in presentation with diarrhea over time and a positive linear trend in patients detected by screening. Trends show patients were diagnosed at an older age since 1980, and there was a significant downward trend in those diagnosed as children or with malignancy. Over the 52 years, there was a markedly significant negative trend in the duration of symptoms.

"Fewer patients present with diarrhea and more are detected through screening. The majority of patients now present as 'silent' celiac disease, with minimal or no symptoms," explained Devi Rampertab, M.D., one of the investigators.

Celiac disease is an autoimmune inflammatory disease of the small intestine. In celiac disease, patients cannot tolerate the protein gluten. The condition causes an autoimmune reaction that damages the small intestine and causes problems absorbing nutrients from food as well as a range of gastrointestinal and other symptoms. Celiac disease generally responds to a gluten-free diet.