Celiac disease is a multisystem disorder triggered by the ingestion of gluten, the main storage protein found in certain grains, including wheat, barley and rye. According to the University of Chicago Celiac Disease Center, approximately 1 in every 133 people is afflicted by this genetically-linked autoimmune disorder. The onset of celiac disease ranges from early infancy to late adulthood. Since teenagers already exhibit a wide range of symptoms related to growth and puberty, it is important not to overlook potential signs of celiac disease in this age group.
The classic symptoms of celiac disease include diarrhea, constipation, abdominal pain, gas and bloating; this is no different in teenagers. Any new bowel symptoms that linger warrant further investigation. Use food journals to tie specific foods to symptoms. If gluten-containing foods seem to be a culprit, seek out celiac disease testing with a gastroenterologist. Lactose intolerance, causing digestive disturbances from ingestion of dairy, is also common due to the destruction of the lactase enzyme in the lining of the small intestine. Bathroom habits may be a sensitive subject with teenagers, but ignoring digestive complaints may delay proper diagnosis.
According to the National Institute of Neurological Disorders and Stroke, epilepsy can result from inflammation in the brain caused by gluten intolerance, especially in children. Other complaints include numbness and tingling in the hands and feet, known as peripheral neuropathy, and frequent migraine headaches. Although parents may assume headaches to be related solely to hormonal fluctuations, celiac disease should be on the list of considerations.
Due to malabsorption of nutrients as a result of damage to the absorptive surface of the small intestine, failure to grow, decreased energy and musculoskeletal abnormalities may occur. Increased appetite and food intake with concurrent loss of weight is a red flag. Drastic decreases in energy could indicate anemia from lack of iron or vitamin B12. Calcium and other mineral deficiencies may cause bone weakness and joint pain. Teenagers who are active in school sports could experience more frequent injury.
Since teenagers are notoriously moody, changes in personality related to a condition like celiac disease are difficult to detect. Persistent depression and anxiety distinct from situational triggers can be present. What exactly causes the depressive tendencies is not well-defined, but the tendencies could be linked to nutrient deficiencies, a reaction to ongoing poor health or an activation of the inflammatory response, according to Peter Green, M.D., and Rory Jones, authors of "Celiac Disease."
Celiac disease is a serious medical condition. Ignoring minor complaints in the teenager with celiac disease confers greater risk for severe medical conditions in adulthood, including autoimmune disease, malignancy and osteoporosis. Dr. Peter Green states that the overall risk for specific cancers in people with celiac disease has been reported at anywhere from nine to thirty-four times greater than for the general population. High-risk malignancies include thyroid cancer, adenocarcinoma of the small intestine and lymphoma.
Identification and Treatment
If celiac disease is suspected, testing for anti-gliadin and tissue transglutaminase antibodies in the blood is the initial step, followed by a biopsy of the small intestine to determine if there is a flattened “villi” pattern. The only treatment for celiac disease is a strict gluten-free diet for life.