Seniors and Celiac Disease
Once thought of as a childhood disorder, celiac disease now is recognized as common in older adults.
Marjorie’s granddaughters were gluten-intolerant, so she prepared the Thanksgiving turkey with rice stuffing, found recipes for gluten-free birthday treats, and was careful not to give the girls wheat products when they visited her home. Then, Marjorie began to experience fatigue and mild abdominal discomfort. Her doctor ran some tests. The diagnosis was celiac disease, which is caused by gluten intolerance and runs in families. Marjorie was surprised that she developed the symptoms so late in life.
Celiac disease is an inherited digestive disorder that occurs in people who cannot tolerate gluten, a protein found in wheat, rye and barley. Most people easily digest gluten, the substance that gives elasticity to breads and other doughs. But when people with celiac disease consume foods containing gluten, their immune systems react by attacking the lining of the small intestine. This can lead to malnutrition, anemia, brittle bones and other health problems. When a person with gluten intolerance continues to eat foods containing the protein, their intestines can sustain further damage.
Doctors once thought that celiac disease only developed during childhood. But researchers from the University of Maryland School of Medicine Center for Celiac Research recently reported that the disease actually becomes more common as we grow older. Researcher Dr. Carlo Catassi, co-director of the Center for Celiac Research, explains, "You're not necessarily born with celiac disease. Our findings show that some people develop celiac disease quite late in life." Exactly why some individuals only develop the disease in their later years is not known.
What are the symptoms of celiac disease?
According to the National Digestive Diseases Information Clearinghouse, seniors with celiac disease may experience one or several of these symptoms:
- Digestive problems, including stomach pain, gas and diarrhea
- Bone or joint pain
- Bone loss
- Depression and anxiety
- An itchy, blistering skin rash
- Tingling or loss of sensation in fingers
How is celiac disease diagnosed?
Celiac disease can be challenging to diagnose in a patient of any age, because its symptoms are similar to those of other digestive disorders, such as irritable bowel disease. Symptoms can be even more subtle in senior patients, who often exhibit only minor gastrointestinal signs. Doctors diagnose the disease using a blood test or a biopsy of the small intestine.
The University of Maryland research team urges physicians to screen their elderly patients for celiac disease, and reminds seniors to be alert for possible symptoms. Study co-author Dr. Alessio Fasano says, "You're never too old to develop celiac disease." The team emphasizes that the correct diagnosis is important: Over time, celiac disease can lead to malnutrition, osteoporosis, liver diseases and cancers of the intestine. Mayo Clinic researchers have even suggested a link between dementia and celiac disease. The longer a person goes undiagnosed, the greater the chance of developing long-term complications.
How is celiac disease treated?
At present, there is only one treatment for celiac disease: following a gluten-free diet. This means choosing foods that do not contain wheat, rye or barley. Giving up bread is only the first step. Gluten is hidden in many products, and diligence is necessary to be sure a person with celiac disease isn’t consuming it unknowingly. Gluten can be found in cold cuts, soup, candy, soy sauce, even in lipstick and medications, so it's important to read food labels carefully. Fortunately, since 2006 the U.S. Food and Drug Administration has required food labels to clearly identify wheat products in the list of ingredients.
The good news is that today many products are available in gluten-free versions. Gluten-free restaurants are opening across the country, and other eateries are offering gluten-free menu items and information on their menus. Grocery stores stock a wider array of gluten-free products. Many churches even offer gluten-free communion wafers these days! Once patients stop eating foods that contain gluten, many notice improvement within a short time.
Switching to a gluten-free diet can be challenging for older adults. After enjoying wheat-containing favorites such as bread, pasta and pizza for many years, it can be hard to give them up. The tiny print on food labels can be hard to read. And when dining out, seniors may be hesitant to ask their server about menu ingredients. Physicians and families should provide support as seniors are making the switch. A nutritionist who is familiar with the dietary issues of older adults can offer suggestions for delicious gluten-free meals and snacks that provide the nutrients seniors need.
The National Institutes of Health Celiac Disease Awareness Campaign provides current, comprehensive, science-based information about the symptoms, diagnosis and treatment of celiac disease. The site also offers resources for following a gluten-free diet.
The Academy of Nutrition and Dietetics offers information about celiac disease and a gluten-free diet.
Seniors may need extra help consuming a diet that supports their special needs. Caring Right at Home offers suggestions on how in-home care helps ensure compliance with special diets.
This article is not meant to replace the advice of your doctor. If you or a senior loved one has been diagnosed with or is experiencing the symptoms of celiac disease, consult a healthcare provider.
Right at Home, Inc. is a national organization dedicated to improving the quality of life for those we serve. We fulfill that mission through a dedicated network of locally owned, franchised providers of in-home care services.