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Misdiagnosis of Celiac Disease

Misdiagnosis of Celiac Disease

Because the symptoms of celiac disease can be vague and mimic many other conditions, a diagnosis can be overlooked or missed. The symptoms of celiac disease may be mistaken for such conditions as irritable bowel syndrome, inflammatory bowel disease, diverticulitis, iron-deficiency anemia caused by menstrual blood loss, intestinal infections, and chronic fatigue syndrome. In addition, blood tests that test for celiac disease may be normal even if the person has the disease.

Some people have such mild symptoms or no symptoms at all, resulting in a delay in seeking medical care and a diagnosis. Despite this, health care providers are becoming more aware of the condition and diagnosis rates are improving....more about Celiac Disease »

Celiac Disease misdiagnosis: Celiac disease may be misdiagnosed as a less serious form of wheat or other food intolerance....more about Celiac Disease »

Celiac Disease misdiagnosis: The chronic digestive disorder celiac disease is not well known and often overlooked. Instead, it is often misdiagnosed as irritable bowel syndrome or another chronic digestive disease. In cases where the main symptoms are non-digestive symptoms such as anemia and fatigue, the condition might be misdiagnosed as chronic fatigue syndrome, depression, or other fatigue-causing disorders.

Celiac disease was cited by Reader's Digest as one of the top 10 misdiagnosed diseases. In the article entitled "10 Diseases Doctors Miss", the 10 diseases mentioned were hepatitis C, lupus, celiac disease, hemochromatosis, aneurysm, Lyme disease, hypothyroidism (underactive thyroid), polycystic ovary syndrome (PCOS), chlamydia, and sleep apnea. 1...more about Celiac Disease »

Alternative diagnoses list for Celiac Disease:

For a diagnosis of Celiac Disease, the following list of conditions have been mentioned in sources as possible alternative diagnoses to consider during the diagnostic process for Celiac Disease:

Diseases for which Celiac Disease may be an alternative diagnosis

The other diseases for which Celiac Disease is listed as a possible alternative diagnosis in their lists include:

Rare Types of Celiac Disease:

Celiac Disease: Medical Mistakes

Related medical mistakes may include:

Celiac Disease: Undiagnosed Conditions

Commonly undiagnosed conditions in related areas may include:

Discussion of diagnosis/misdiagnosis of Celiac Disease:

Celiac disease could be underdiagnosed in the United States for a number of reasons:

  • Celiac symptoms can be attributed to other problems.

  • Many doctors are not knowledgeable about the disease.

  • Only a handful of U.S. laboratories are experienced and skilled in testing for celiac disease.

More research is needed to find out the true prevalence of celiac disease among Americans. (Source: excerpt from Celiac Disease: NIDDK)

Common Misdiagnoses and Celiac Disease

Chronic digestive conditions often misdiagnosed: When diagnosing chronic symptoms of the digestive tract, there are a variety of conditions that may be misdiagnosed. The best known, irritable bowel syndrome, is over-diagnosed, whereas other causes that are less known may be overlooked or misdiagnosed: celiac disease, Crohn's disease, ulcerative colitis (both are called inflammatory bowel disease (IBD)), diabetic gastroparesis, diabetic diarrhea. Other possibilities include giardia, colon cancer, or other chronic infections.

Intestinal bacteria disorder may be hidden cause: One of the lesser known causes of diarrhea is an imbalance of bacterial in the gut, sometimes called intestinal imbalance. The digestive system contains a variety of "good" bacteria that aid digestion, and they can decline for various reasons, leading to digestive symptoms such as diarrhea. The main treatment is to eat foods containing probiotics, typically yoghurt cultures. See intestinal imbalance and probiotics.

Antibiotics often causes diarrhea: The use of antibiotics are very likely to cause some level of diarrhea in patients. The reason is that antibiotics kill off not only "bad" bacteria, but can also kill the "good" bacteria in the gut. This leads to "digestive imbalance" where there are too few remaining "good" bacteria in the digestive system. The treatment is typically to use "probiotics", such as by eating yoghurt cultures containing more of the good bacteria. See digestive imbalance and probiotics.

Food poisoning may actually be an infectious disease: Many people who come down with "stomach symptoms" like diarrhea assume that it's "something I ate" (i.e. food poisoning). In fact, it's more likely to be an infectious diarrheal illness (i.e. infectious diarrhea), that has been caught from another person. Such conditions may be transmitted via the fecal-oral route.

Mesenteric adenitis misdiagnosed as appendicitis in children: Because appendicitis is one of the more feared conditions for a child with abdominal pain, it can be over-diagnosed (it can, of course, also fail to be diagnosed with fatal effect). One of the most common misdiagnosed is for children with mesenteric adenitis to be misdiagnosed as appendicitis. Fortunately, thus misdiagnosis is usually less serious than the reverse failure to diagnose appendicitis.

Celiac disease often fails to be diagnosed cause of chronic digestive symptoms: One of the most common chronic digestive conditions is celiac disease, a malabsorption disorder with a variety of symptoms (see symptoms of celiac disease). A variety of other chronic digestive disorders tend to be diagnosed rather than this condition. See introduction to celiac disease or misdiagnosis of celiac disease.

Undiagnosed celiac disease in pregnancy harms fetus: The failure to diagnose the common but less known digestive disease celiac disease (see symptoms of celiac disease) is linked to adverse fetal outcomes. See misdiagnosis of celiac disease.

Vitamin B12 deficiency under-diagnosed: The condition of Vitamin B12 deficiency is a possible misdiagnosis of various conditions, such as multiple sclerosis (see symptoms of multiple sclerosis). See symptoms of Vitamin B12 deficiency or misdiagnosis of multiple sclerosis.

Chronic digestive diseases hard to diagnose: There is an inherent difficulty in diagnosing the various types of chronic digestive diseases. Some of the better known possibilities are peptic ulcer, colon cancer, irritable bowel syndrome, or GERD. Other sometimes overlooked possibilities include Crohn's disease, ulcerative colitis, chronic appendicitis, Celiac disease, Carcinoid syndrome, gastroparesis, and others. See all types of chronic digestive diseases.

Celiac Disease: Rare Types

Rare types of medical disorders and diseases in related medical areas:

Failure To Diagnose Celiac Disease

Failure to diagnose Celiac Disease may be associated with the following:

  • Celiac disease is rare in Jews, Asians, Blacks and Mediterranean populations and is hence is often not considered as a possible diagnosis even when patients from these populations present with the symptoms
  • Failure to diagnose celiac disease can result in ulcers which may bleed or become perforated which can lead to further problems
  • Undiagnosed celiac disease can also lead to malabsorption and maldigestion which can lead to complications such as malnutrition, osteopenia and neurological symptoms such as seizures
  • Undiagnosed celiac disease can result in poor growth due to lack of nutrients
  • Undiagnosed or untreated celiac disease increases the risk of birth deformities and miscarriage in pregnant women
  • Many cases of celiac disease may not be diagnosed until middle age or even later in life. Symptoms may be evident during infancy but may ease by adolescence and then flare up again later in life. Thus it is important to assess the health history from infancy when diagnosing adults
  • Undiagnosed and untreated patients face an increased risk of developing gastrointestinal adenocarcinoma and lymphoma
  • Many celiac patients are totally unaware that they have the conditions and either have minimal symptoms are put their symptoms down to other causes such as lifestyle stress
  • The longer celiac disease is undiagnosed, the greater the damage to the intestines. The more damaged the intestines are, the more difficult is the recovery process with some people never achieving normal intestinal functioning no matter how closely they follow the treatment regimen
  • Symptoms are usually less severe during the teenage years and hence teenagers are frequently undiagnosed
  • Some celiac sufferers have no symptoms and are thus not diagnosed but they still face the risks associated with the condition e.g. malnutrition, anemia, poor growth and weight loss
  • A delayed diagnosis may result in irreversible symptoms such as retarded growth or discoloured teeth
  • Many diabetic children with celiac disease remain undiagnosed because celiac disease is quite often asymptomatic in diabetic children. Some experts believe it is important to screen diabetic children for celiac disease to prevent irreversible complications. Poor growth in diabetic children also suffering from celiac disease is often attributed to poor glycemic control
  • Some research indicates that undiagnosed celiac disease may increase the risk of other autoimmune disorders
  • Due to the fact that some celiac suffers display few if any noticeable symptoms, health professionals should consider celiac testing for patients who have: a family history of celiac disease, thyroid disease, type I diabetes, irritable bowel syndrome, anemia, chronic diarrhea, chronic fatigue, unexplained weight loss, epilepsy, infertility, short stature or increased transaminase levels for no apparent reason

Notes On Hidden Causes Of Celiac Disease

The following may be hidden causes of Celiac Disease:

  • There is no known definitive cause of celiac disease but environmental and immunological factors are believed to play a role as well as genetic predisposition
  • Some studies indicate that the age of onset of symptoms is determined by the strength of the genetic factors involved
  • Onset of symptoms in an undiagnosed patient may be triggered by emotional or physical stress such as moving away from home to go to university, illness or pregnancy
  • Adults (especially mothers) who develop celiac symptoms tend to assume their symptoms are due to stress or dairy intolerance and don't seek medical attention

Notes On Wrong Diagnosis Of Celiac Disease

Wrong diagnosis of Celiac Disease may be associated with the following:

  • Celiac disease has a wide range of possible symptoms which are similar to other condition which can lead to a misdiagnosis
  • There is some disagreement amongst professionals over whether a negative biopsy definitively proves the absence of celiac disease in patients suffering from celiac symptoms. If there is a lack of confidence about a negative test result, a trial gluten-free diet will provide information about whether gluten may be a factor in the stomach problems

Complications Of Misdiagnosis Of Celiac Disease

The following may be complications of misdiagnosis of Celiac Disease:

  • Delayed puberty due to undiagnosed celiac disease may be misdiagnosed as a hormonal problem
  • Irritability and depression associated with undiagnosed celiac disease may be misdiagnosed as a psychiatric disorder
  • Mouth sores and skin rashes due to celiac disease may be misdiagnosed simply as an independent skin disorder
  • Anemia and fatigue due to mild celiac disease in adults may be diagnosed simply as anemia
  • Celiac patients whose bowel habits tend towards constipation may be misdiagnosed a irritable bowel syndrome
  • Osteoporosis due to celiac disease may be diagnosed simply as osteoporosis due to an inadequate calcium levels in their diet
  • Infertility caused by celiac disease may be misdiagnosed as a hormonal problem
  • Dental enamel defects caused by undiagnosed celiac disease may be put down to poor oral hygiene or a poor diet
  • The skin rash caused by celiac disease is sometimes misdiagnosed as eczema

Other Notes On Misdiagnosis Of Celiac Disease

  • Treatment compliance is a big issue for celiac patients as the diet can be quite restrictive
  • Relatives of celiac patients should be tested for the disorder whether they have symptoms or not as the condition may be inherited but some people may not suffer any noticeable symptoms
  • A significant number of patients with type 1 diabetes and Down syndrome will also have celiac disease and should hence be tested for the condition whether they have symptoms or not
  • Celiac sufferers need to be aware that some medications may have gluten as an ingredient and hence it is important to carefully check labels and to inform any health professional they may visit of their condition
  • Celiac patients tend to also have other autoimmune conditions such as type 1 diabetes, liver disease, rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus and thyroid disease. The autoimmune conditions and celiac disease may be genetically linked
  • There is no cure for celiac disease but symptoms can be managed through measures such as a gluten-free diet
  • Some studies indicate that celiacs who only partially limit their gluten ingestion or don't limit it all have a much greater risk of developing cancers (mouth, pharynx, esophagus, small bowel) than celiacs who maintain a strict diet

Medical news summaries about misdiagnosis of Celiac Disease:

The following medical news items are relevant to misdiagnosis of Celiac Disease:

General Misdiagnosis Articles

Read these general articles with an overview of misdiagnosis issues.

About misdiagnosis:

When checking for a misdiagnosis of Celiac Disease or confirming a diagnosis of Celiac Disease, it is useful to consider what other medical conditions might be possible misdiagnoses or other alternative conditions relevant to diagnosis. These alternate diagnoses of Celiac Disease may already have been considered by your doctor or may need to be considered as possible alternative diagnoses or candidates for misdiagnosis of Celiac Disease. For a general overview of misdiagnosis issues for all diseases, see Overview of Misdiagnosis.



Footnotes:
1. Reader's Digest, February 2004, "10 Diseases Doctors Miss", page 120
 

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