Celiac Disease: Age & Life Stages

Celiac disease (CD) is a genetic autoimmune disorder that mainly affects the gastrointestinal tract when gluten is ingested. When someone with CD consumes gluten, the lining of the small intestine gets damaged and is unable to absorb nutrients properly.

Celiac disease affects at least 1% of the population. About 83% of people with CD are undiagnosed. The genes known to be associated with Celiac disease are HLA-DQ2 and HLA-DQ8. When a first-degree (parent of the person) family member has CD, the probability of it developing among their heirs increases significantly. It can develop at any age and affects individuals of all ethnicities.

In India, Celiac disease was first identified in northern India, primarily in children, in the 1960s. A community-based study in Ludhiana that involved a step-wise approach to case detection and diagnosis estimated that celiac disease was prevalent at least in 1 of 310 individuals. The fact that the disease affects adults is also now well-recognized and documented. The prevalence of celiac disease in southern India is not known, as rice is the staple cereal in south India or due to differences in genetic makeup.

Age and life stage play a big role in how long it could take to identify and get a proper diagnosis. They also dictate one’s ability to adjust to living gluten-free. People may experience one or a variety of symptoms that could point towards Celiac Disease. Only through proper testing, can one identify the true cause of Celiac Disease which could be — the genetic variation, family history, gluten from food, or gene triggering at certain life stages such as pregnancy, childhood, surgery, antibiotic exposure, or infection resulting in an imbalance of bacteria in the gut.

Symptoms can surface at any age and includes abdominal bloating, constipation, diarrhoea, fatigue, liver, and elevated enzymes: ALT (Alanine transaminase, an enzyme found in the liver) and AST (Aspartate aminotransferase, an enzyme present in the liver and heart cells) and short stature or growth problems. Research shows that over 60% of people diagnosed with CD are biologically female. Some symptoms are very specific and have not been diagnosed or treated over a large number of patients- including the late onset of menstruation or missed periods, miscarriages, and infertility.

Undiagnosed CD in adulthood is often diagnosed with other autoimmune diseases that are common among older people. A person’s age and life stage can present additional challenges to pinpointing what is wrong. Changing eating habits and switching to a gluten-free diet could prove challenging for older people when compared with someone who is relatively younger. 

Celiac disease is not a rare disease and usually shows itself after a life event such as surgery, pregnancy, viral infections, or severe emotional stress. The process of digestion ends in the small intestine which is lined with tiny, fingerlike protrusions, called villi.

Villi are responsible for absorbing nutrients in the intestine. Celiac disease hurts the villi directly. At any stage of life, if celiac disease is not diagnosed and managed well, nutrients will pass through the small intestine without being absorbed and you might become malnourished or deficient in important vitamins and minerals.