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Coeliac disease.

Hugh Freeman1, Michel Lemoyne, Pierre Pare

  • 1University of British Columbia, University of British Columbia (UBC) Hospital, Vancouver, Canada.

Best Practice & Research. Clinical Gastroenterology
|April 30, 2002
PubMed
Summary
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Coeliac disease is increasingly detected in older adults, often presenting with weight loss, diarrhea, and anemia. Delayed diagnosis in elderly patients elevates risks for autoimmune conditions, cancers like lymphoma, and bone diseases.

Area of Science:

  • Gastroenterology
  • Geriatrics
  • Internal Medicine

Background:

  • Coeliac disease diagnosis rates are rising in elderly populations due to increased awareness and improved screening.
  • Clinical manifestations in older adults are often shaped by prolonged, undiagnosed subclinical disease.
  • Common presentations include weight loss, diarrhea, and iron deficiency anemia.

Purpose of the Study:

  • To highlight the diagnostic challenges and clinical features of coeliac disease in the elderly.
  • To emphasize the increased risks of complications associated with delayed diagnosis in this demographic.
  • To advocate for a systematic approach to the investigation and management of coeliac disease in older adults.

Main Methods:

  • Review of clinical presentations and diagnostic findings in elderly coeliac disease patients.

Related Experiment Videos

  • Analysis of the association between delayed diagnosis and subsequent complications.
  • Evaluation of common comorbidities and long-term outcomes.

    • Main Results:

    • Weight loss, diarrhea, and iron deficiency anemia are prevalent in elderly coeliac disease patients.
    • Delayed diagnosis significantly increases the risk of autoimmune diseases (e.g., thyroid disease), neoplasms (primarily small bowel lymphoma), and metabolic bone diseases (e.g., osteopenia).
    • Osteopenia is frequently observed, often severe, necessitating specific treatment beyond a gluten-free diet.

    Conclusions:

    • Coeliac disease in the elderly often presents insidiously, with significant risks if diagnosis is delayed.
    • Early detection and management are crucial to mitigate severe complications like lymphoma and bone disease.
    • A structured diagnostic and therapeutic strategy is essential for optimizing outcomes in elderly coeliac disease patients.