You’re seemingly considerably accustomed to celiac illness, a critical autoimmune dysfunction that causes sure individuals to expertise small gut harm after they eat gluten.
Those stricken typically expertise gastrointestinal signs like abdomen ache, bloating, constipation, gasoline and diarrhea. But not everybody does. In reality, you may have “silent celiac” and do not know.
Below, GI specialists clarify what silent celiac is, the way it’s identified and handled and what to look out for.
What is silent celiac?
“‘Silent’ celiac disease is when someone has celiac disease, a reaction to the gluten protein, but they do not manifest symptoms from the disease,” stated Dr. Rabia De Latour, a gastroenterologist and assistant professor of medication at NYU Grossman School of Medicine. “They can have the physical manifestations of the disease like small bowel inflammation but without the GI symptoms like diarrhea and abdominal pain.”
As such, the type of celiac typically known as “silent” celiac may also be known as “asymptomatic” celiac.
“This is a rare form of celiac, as usually patients develop GI symptoms from the malabsorption, which is secondary to the intestinal damage caused by the celiac disease,” stated Dr. Kevin Cronley, a gastroenterologist with Gastro Health in Cincinnati.
Although the thought of silent celiac presumes you don’t have any signs of the illness, some individuals may merely not notice they’re experiencing delicate signs.
“For probably a portion of those patients who think they have no symptoms, they discover that they did have symptoms and feel much better once they go on a gluten-free diet,” stated Dr. David Kastenberg, chief of the division of gastroenterology and hepatology at Jefferson Health within the Greater Philadelphia space. “They weren’t aware that they had symptoms because they thought things like headaches, joint aches, chronic sinus problems or muscle aches were just part of their normal everyday life rather than celiac.”
How is it identified?
Because this manifestation of celiac illness doesn’t contain clear signs, many individuals go undiagnosed.
“Silent celiac disease is underdiagnosed, and physicians should have a low threshold to test for it if there are any laboratory abnormalities suggestive of celiac, family history of celiac disease, or other conditions which celiac can be associated with,” Cronley stated.
As he famous, additional inspection of lab abnormalities are usually the best way individuals with the illness wind up with a analysis.
“Someone might have silent GI symptoms but may have abnormal lab findings or nonspecific generalized symptoms like fatigue and headaches,” De Latour famous. “Going to your doctor for regular checkups with appropriate blood work can pick up the lab work signs of celiac before your symptoms might. Someone might have blood work findings suggesting they are not absorbing certain nutrients well from their food due to the gut inflammation.”
If a affected person’s bloodwork reveals iron deficiency or elevated liver operate, as an example, docs might then verify for celiac by doing a blood check for sure antibodies, like tissue transglutaminase antibody. They may also do an higher endoscopy to take a look at the GI tract and take a pattern of tissue from the small gut.
“Silent celiac might be ‘unsilenced’ if someone is getting an upper endoscopy for something separate like acid reflux and the findings suggest celiac, leading them to go on and do blood tests,” Kastenberg stated. “People also need to take notice when someone is at a higher risk for having celiac, like having a first-degree relative with celiac or concomitant medical problem like autoimmune thyroid disease.”
He famous that circumstances like kind 1 diabetes, Down syndrome and sure pores and skin rashes are additionally related to elevated threat of celiac illness.
How is it handled?
The excellent news is there’s a transparent and efficient remedy for celiac illness, silent or in any other case. The dangerous information is it requires an enormous way of life change.
“The treatment for celiac disease is a gluten-free diet,” Cronley stated. “Gluten is a protein that is found in wheat that the body will confuse with the lining of the patient’s intestines, causing damage to the intestines. This intestinal injury can result in symptoms of malabsorption, vitamin deficiencies, and can increase the risk of cancer of the small intestine.”
To take away this dangerous protein from the equation and scale back the irritation, sufferers should fully lower gluten out of their diets.
“For sicker patients, there are more intense therapies, but this is less common,” De Latour famous.
Fortunately, there’s now extra consciousness and understanding round gluten-free consuming than up to now.
“Gluten-free diets are popular right now because in general, people feel better on a gluten-free diet by eating less processed foods,” Cronley stated. “If you think you may have celiac, seek an evaluation by a physician who can properly evaluate you for the disease.”
Once you get the celiac analysis, it’s essential to make these dietary modifications, even when you don’t really feel signs after consuming gluten.
“Silent celiac is really celiac disease, so it’s serious,” Kastenberg stated. “It’s hard for people to accept that when they feel perfectly fine. If you feel terrible when you have gluten, you get that feedback that you shouldn’t eat that thing. But if you aren’t so sensitive and can eat gluten all the time without feeling it, you aren’t getting that feedback that it’s a problem for you.”
But you’ll want to acknowledge that silent celiac ought to be taken simply as severely. Ignoring it may well result in long-term points.
“Even if you feel well, your small intestine is not well,” Kastenberg emphasised. “It’s not functioning properly, and there are lots of potential consequences like an increased risk for osteoporosis, nutritional deficiencies, malignancies and even reproductive and pregnancy-related issues like low birth weight or spontaneous abortion. If you have celiac, it’s important to tell your family members to get screened as well. Catching it early makes a big difference.”