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Abstract

Recent epidemiological studies primarily from Europe document that adult celiac disease often lacks the classic presentation of steatorrhea and weight loss. There are few surveys of adult celiac disease in the United States. We surveyed the large population of a nationwide patient support group to determine their disease presentations. In the initial survey (N = 1032 respondents), the median age at onset was 46 years, and the diagnosis of adult celiac disease was often delayed (median 12 months, with 21% delayed over 10 years). Only 32% of adults were underweight, and only about 50% reported frequent diarrhea and weight loss. A second survey documented that common presenting symptoms were fatigue (82%), abdominal pain (77%), bloating or gas (73%), and anemia (63%). Initial physician diagnoses were often irritable bowel syndrome (37%), psychological disorders (29%), and fibromyalgia (9%). These initial presentations are similar to those in Europe and often resemble irritable bowel syndrome.

Celiac disease and fibromyalgia: Is there an association?

“…Our findings are different from those of Rodrigo et al, who established a 7% prevalence of CD and 56% of lymphocytic enteritis in duodenal biopsies corresponding to a Marsh type 1 lesion studying 104 FM patients with associated IBS (2). Zipser et al (5), investigating 134 CD patients, found FM in 9% of them, while the prevalence of FM in general population is estimated to reach 5% (8). On the other hand, Tovoli et al (6) described that the overall prevalence of CD in FM patients was similar to that expected otherwise, as we did.…”

“…Data from literature is controversial (2,5,6). After approval of the local Committee for Ethics in Research and written consent from all participants, we investigated this issue by studying 188 women for IgA EmA and IgG anti-tTG.…”

Advances in Diagnosis and Management of Celiac Disease

“…Patients may report fibromyalgia or arthralgia, which might not always respond to a GFD. 9 Young adults with celiac disease might also be at increased risk of early atherosclerosis. 10 In addition, microvascular complications can accelerate in patients who also have type 1 diabetes.…”

Remarkable prevalence of coeliac disease in patients with irritable bowel syndrome plus fibromyalgia in comparison with those with isolated irritable bowel syndrome: a case-finding study

“…In recent years, a possible causal link between IBS, FMS and multisymptom forms of adult CD has been suspected on the basis of some cases with overlapping symptoms involving gastrointestinal, musculoskeletal and other body systems that have had similar clinical features [25,26]. In addition, a few case reports describing isolated patients with FMS and CD simultaneously, all of whose symptoms dramatically resolved after the removal of gluten from their diet, have been reported [27,28].…”

“…The available level of scientific evidence supporting the association of CD with FMS is mostly limited to a low-powered, cross-sectional study in which a 2% incidence of CD was detected among 50 American adolescents with FMS [27], an American nationwide survey reported that FMS was the physician’s initial diagnosis in 9% of 134 patients later diagnosed with CD [25]. Two case reports in the literature have described, respectively, a child [27] and three women [28] with comorbid FMS and CD, all of whose symptoms resolved very well once gluten was removed from their diet.…”