Yes, it’s possible to develop celiac disease later in life, even if you didn’t have it in childhood. The condition can appear at any age, triggered by various factors.
Can Celiac Disease Develop Later In Life?
Celiac disease is most commonly diagnosed in childhood, but many people develop it later in life, even well into adulthood. This surprising fact often catches people off guard, as they may believe the condition only affects children. However, medical research shows that celiac disease can appear at any point during a person's life, even in individuals who have lived without symptoms for decades.
What Is Celiac Disease?
Celiac disease is an autoimmune disorder in which the ingestion of gluten—a protein found in wheat, barley, and rye—damages the small intestine. This damage interferes with the absorption of essential nutrients, leading to a range of symptoms that can affect almost any part of the body. Common symptoms include digestive issues like bloating and diarrhea, as well as skin rashes, joint pain, and neurological symptoms. Left untreated, celiac disease can lead to serious complications such as malnutrition, osteoporosis, and an increased risk of certain cancers.
Celiac disease is hereditary, meaning it runs in families. If you have a first-degree relative with the condition, you have a higher risk of developing it yourself. However, not everyone with a genetic predisposition will develop the disease. Environmental factors, such as stress, infections, or dietary changes, can trigger the onset of celiac disease in genetically susceptible individuals.
Can You Develop Celiac Disease Later In Life?
Yes, it is possible to develop celiac disease later in life, even if you have been consuming gluten without issue for years or decades. In fact, about one-quarter of people with celiac disease are diagnosed after the age of 40. While the disease is often diagnosed in childhood or early adulthood, many cases go undetected for years or are mistaken for other conditions like irritable bowel syndrome (IBS), lactose intolerance, or other gastrointestinal disorders.
The reasons why celiac disease may emerge later in life aren’t entirely understood, but researchers have identified several factors that could contribute to the delayed onset. These include genetic changes, changes in the immune system, and environmental triggers.
Risk Factors for Developing Celiac Disease Later in Life
While celiac disease is primarily a genetic disorder, several factors can contribute to its late onset:
1. Genetic Predisposition
Celiac disease is strongly linked to genetics. The vast majority of people with celiac disease carry one of two genetic markers: the HLA-DQ2 or HLA-DQ8 gene. However, having these genes alone doesn’t guarantee that you will develop the disease. Other environmental triggers, such as stress, infection, or changes in diet, may play a role in the development of celiac disease later in life.
2. Changes in the Immune System
As people age, their immune systems undergo changes. In some cases, the immune system may become more prone to attacking the body’s tissues, leading to autoimmune conditions like celiac disease. This can help explain why celiac disease may manifest later in life, even in people who have been eating gluten without problems for many years.
3. Infections and Illnesses
Infections, especially gastrointestinal ones, have been linked to the onset of celiac disease. A viral infection or foodborne illness can potentially trigger the immune system to start attacking the small intestine in a genetically predisposed individual. Stressful events and major surgeries have also been known to trigger autoimmune responses in some people, leading to the onset of celiac disease.
4. Changes in Diet or Lifestyle
Sudden or significant changes in diet or lifestyle can also contribute to the development of celiac disease later in life. A change in eating habits, such as consuming more gluten-rich foods, or changes in the gut microbiome due to factors like antibiotics or diet, may provoke the onset of the disease in some individuals. For instance, someone may develop celiac disease after years of eating a gluten-free diet due to an infection or immune system change.
Symptoms of Celiac Disease in Adults
The symptoms of celiac disease in adults can vary widely, and many of them are nonspecific, making it difficult to diagnose the condition. Some individuals may experience only mild symptoms, while others may experience severe reactions. The most common symptoms of celiac disease in adults include:
1. Digestive Symptoms
- Bloating and gas: A common symptom of gluten intolerance that can cause discomfort.
- Diarrhea or constipation: Some people with celiac disease experience chronic diarrhea, while others may become constipated.
- Abdominal pain: Chronic stomach cramps or discomfort, often after eating foods containing gluten.
- Nausea and vomiting: These symptoms can occur after ingesting gluten and may be mistaken for other gastrointestinal issues.
2. Non-Digestive Symptoms
- Fatigue and weakness: Many individuals with celiac disease report feeling exhausted or weak, even if they are getting adequate rest.
- Joint pain: Inflammation caused by the immune response can result in pain or stiffness in the joints.
- Headaches or migraines: Neurological symptoms like headaches and migraines are common in people with celiac disease.
- Skin rashes: Dermatitis herpetiformis, an itchy skin rash, is a hallmark symptom of celiac disease.
3. Long-Term Complications
Untreated celiac disease can lead to long-term health problems, such as:
- Osteoporosis: Reduced calcium absorption can weaken bones, leading to a higher risk of fractures.
- Infertility or miscarriage: Women with untreated celiac disease may experience infertility or complications during pregnancy.
- Neurological disorders: Persistent nutrient malabsorption can affect the nervous system, leading to issues such as peripheral neuropathy.
Diagnosing Celiac Disease Later in Life
Diagnosing celiac disease in adults can be challenging, especially if the person has been eating gluten without issue for years. Because the symptoms can mimic other conditions, many people are misdiagnosed with IBS, lactose intolerance, or other gastrointestinal disorders. The process for diagnosing celiac disease includes several steps:
1. Blood Tests
The first step in diagnosing celiac disease is usually a blood test to measure the levels of antibodies in the bloodstream. The most common blood test looks for anti-tissue transglutaminase antibodies (tTG-IgA), which are typically elevated in people with celiac disease. If this test is positive, further tests may be done to confirm the diagnosis.
2. Biopsy of the Small Intestine
A biopsy of the small intestine is the definitive test for celiac disease. During this procedure, a doctor removes a small sample of tissue from the small intestine to examine for damage caused by the immune response to gluten. This damage is characterized by the flattening of villi, the small finger-like projections that help absorb nutrients.
3. Genetic Testing
Genetic testing may also be done to check for the presence of the HLA-DQ2 or HLA-DQ8 gene markers. While these genes are not definitive indicators of celiac disease, their presence can help determine if someone is at higher risk.
Treatment for Celiac Disease
There is currently no cure for celiac disease, but the condition can be effectively managed with a strict gluten-free diet. Eliminating gluten from the diet allows the small intestine to heal and helps alleviate symptoms. However, even trace amounts of gluten can trigger an immune response and damage the small intestine, so it’s important to avoid gluten entirely.
In addition to a gluten-free diet, people with celiac disease may require nutritional supplements to correct deficiencies in vitamins and minerals, such as iron, calcium, and vitamin D. In some cases, medications may be prescribed to help manage symptoms.
Conclusion: Can I Develop Celiac Disease Later In Life?
Yes, celiac disease can develop later in life, even if you’ve been consuming gluten without issue for many years. The condition is genetically predisposed, but environmental factors such as infections, changes in diet, or changes in the immune system can trigger its onset. If you experience digestive or non-digestive symptoms that could be related to celiac disease, it’s important to seek medical advice and undergo testing. Early diagnosis and adherence to a gluten-free diet can help prevent complications and improve quality of life.