clinical features

Last reviewed 04/2022

Coeliac disease was regarded as a rare disease which usually presented in childhood with symptoms of malabsorption - weight loss, chronic diarrhoea, or failure to thrive. This is known as “classical” coeliac disease and remains relatively rare.

At present coeliac disease is considered to be a common condition presenting with “non-classical” symptoms during the adulthood (usually in the fourth or fifth decade of life). Non-classical presentations include irritable bowel syndrome-type symptoms, abdominal pain, altered bowel habit, and anaemia (most commonly iron deficiency) (1)

In addition, patient may be asymptomatic (also formerly known as silent celiac disease) - despite having characteristic intestinal lesion patients do not have any symptom (even in response to detailed questioning) (2).

Hence a clinician should be aware of this diversity of symptoms of coeliac disease, which may not include abdominal symptoms or signs of malabsorption (1)

In general clinical features of coeliac disease can be discussed in terms of:

• presentation in infancy
• presentation in adults:
• typical
• atypical

Reference:

• (1) Mooney PD, Hadjivassiliou M, Sanders DS. Coeliac disease. BMJ. 2014;348:g1561