Why Do Many People With Celiac Disease Go Undiagnosed?

Celiac disease is a lot more common than you might realize. This autoimmune disease manifests in people who are genetically disposed to gluten ingestion, causing damage to the lining of their small intestines. This impairment, in turn, prevents the absorption of nutrients into the body, which, as you can imagine, makes celiac disease extremely severe.

The problem is that celiac disease doesn’t always manifest in this way. In fact, medical practitioners only diagnose about 30% of people with the disease immediately, as the others simply don’t display the symptoms. This undiagnosed majority is known as having silent celiac disease.

Silent and Diagnosed Celiac Disease Differences

If you have silent celiac disease, you’ll only have hidden symptoms of celiac disease. There will be no indicators of gluten intolerance (GI), like abdominal pain, constipation or diarrhea, evident in people with identifiable celiac disease. When people with celiac disease eat gluten —  a protein present in wheat, barley and rye  — their body fights it via an immune response that attacks the small intestine’s lining called the villi.

Without any related conditions like anemia or thyroid disease involved, medical professionals may initially discount celiac disease as a diagnosis due to the absence of usual GI-related symptoms. The injury to the small intestine’s lining, or villous atrophy of the villi, is still likely but remains harder to detect. When celiac disease is undiagnosed and silent, it can cause health conditions that may be devastating in the long term, including:

• Heart disease
• Liver failure
• Small intestine cancer
• Osteoporosis
• Infertility
• Anemia
• Pancreatitis
• ADHD, seizures, dementia and other neurological disorders
• Malnutrition
• Gall bladder problems
• Lactose intolerance
• Mineral and vitamin deficiencies

The younger your age at diagnosis, the less chance you have of developing any of the other conditions listed. As Celiac disease is hereditary, it makes sense that you undergo a Celiac screening if you have family members who display symptoms of GI. A celiac screening will identify the presence of the disease without noticeable symptoms.

Having an Autoimmune Condition Could Be a Warning

If you or somebody you know has a preexisting autoimmune or other condition, it’s advisable to have a celiac screening. Many people with existing conditions of this nature could also have symptomatic or silent celiac disease, with eating gluten otherwise exacerbating its onset. If you have one or more of the following, go for a screening to determine whether celiac disease may be present:

• Addison’s disease
• Anemia
• Berger’s disease
• Chron’s disease
• Chronic fatigue syndrome
• Cirrhosis
• Dermatitis Herpetiformis
• Diabetes (Type 1)
• Down syndrome
• Endometriosis
• Fibromyalgia
• Gluten ataxia
• Hashimoto’s thyroiditis
• Infertility
• Inflammatory Bowel Disease
• Irritable Bowel Syndrome
• Juvenile Idiopathic Arthritis
• Liver disease
• Lupus
• Lymphocytic Colitis
• Multiple Sclerosis
• Obesity
• Pancreatitis
• Peripheral Neuropathy
• Psoriasis
• Schizophrenia
• Sjögren’s Syndrome
• Turner Syndrome
• Williams Syndrome

Beliefs exist that a gluten-free diet could benefit those with the above conditions, although hard evidence supporting these is lacking. 

Celiac disease can also lead to cancers like Non-Hodgkin lymphoma, Small Intestinal adenocarcinoma, Esophageal carcinoma, Papillary Thyroid cancer and Melanoma. Indications show that following a rigorous five-year gluten-free diet minimizes the risk of some cancers, although no studies prove this.

The unknown presence of silent celiac disease means the risks of contracting another condition are likely higher than the symptomatic version. Constant monitoring after diagnosis, along with a rigid gluten-free diet, brings down the risk factor, so should you suspect you have silent celiac disease, seek medical assistance sooner rather than later.

Are You Gluten Intolerant if You Have Silent Celiac Disease?

Although silent celiac disease is asymptomatic, as you don’t experience the standard GI-related digestive symptoms, the damage to your villi and small intestine still takes place and will increase if you continue eating gluten. So, even if you’re feeling no ill effects, your body still reacts negatively to the gluten intake, and you should move to a gluten-free diet immediately. 

It’s as challenging to remain on a gluten-free diet as it is to diet in other ways, especially when you’ve got no adverse symptoms. Continuing to eat gluten, though, even if only sporadically, prevents your intestines from healing, negating any positive effects you’ve gained from being gluten-free in the first place. 

What is a Gluten-Free Celiac Diet?

Gluten-free celiac diets are regular gluten-free diets, so there’s no need to differentiate. All it means is that you should pass on any grain products so they can be tasty and very nutritious. In 2010, specialists believed around three million Americans had celiac disease, with 95% undiagnosed. 

Since then, GI has been well publicized and recognized globally, and many retailers and restaurants include gluten-free options on their shelves and menus. For example, many pizza chains offer gluten-free takeaway pizzas as options.

Some Tips for Takeaways

• Chinese food: Avoid soy sauce and wheat noodles. Choose gluten-free rice noodles instead. Also, check that all meat, vegetables, and fish are cooked without soy sauce and fresh oil.
• Fish and chips: Don’t eat chips fried in old oil, especially with fish batter. Removing batter from fish won’t remove gluten, which immediately contaminates the fish when it’s fried.
• Indian food: Lentils are excellent gluten-free options, along with poppadoms made from lentil flour and rice. Indian food uses chickpea flour or yogurt with no wheat starches, but it’s still better to check.

As a gluten-intolerant person, you’re free to eat the vast majority of available foodstuff, but you should always be aware of the labels on the packaging. Be mindful that the avenin protein found in oats has a similar makeup to gluten, so if you experience any side effects, perhaps pass on your bowl of oatmeal. If you have silent celiac disease, maybe err on the side of caution in this instance. However, the law requires all grains containing gluten to mention the same on their packaging.  

Many grain-like products are gluten-free, including many cereals, starches and flours. You can eat buckwheat, corn, lentils, peas, beans, sorghum, tapioca, sago, soy and many other products, so do your research — life without gluten is quite livable.

Silent Celiac Disease is Serious

Silent celiac disease is potentially more serious than its diagnosable alternative — purely as it can work at depleting your small intestinal function without your knowing it for long periods. If you have gluten-intolerant family members, be safe and get screened for celiac so that you can immediately begin a gluten-free diet and start repairing any damage done before it’s too late.