Doctors have broken celiac disease into four different types of presentations – typical, atypical, silent, and latent. I think this is pretty awesome that they have broken these down. Let’s talk a little about them.
Typical Celiac – This is a “normal” presentation of celiac with symptoms of intestinal malabsorption, chronic diarrhea, slow or no growth, lack of appetite, vomiting, and bloating.
Atypical Celiac – This is celiac disease but with extra intestinal symptoms. Iron deficiency anemia, an increase in hepatic transaminase, recurring abdominal pains, dental enamel issues, dermatitis herpetiformis, or short stature in school aged children. It takes longer to get diagnosed with this type of celiac because it isn’t “typical”.
Silent Celiac – These are the most hearty of the celiac stock! They have positive blood tests and positive intestinal biopsy, but no outward symptoms. Its like they weather the celiac storm without ruffling a feather.
Latent or Potential Celiac – This is a category has two options. The first is where the blood tests are positive but there is no mucosal damage in the small intestine. It is not clear if this ever fully develop or not. It could mean an incorrect blood test or a variety of other factors. The second is where individuals with normal mucosal morphology (no villous blunting) but known to have had a celiac at some point in their life.
Latent celic is almost as if someone’s gut has healed after a celiac diagnosis.
Potential celiac is probably the most controversial of all of the diagnosis. Do you start a gluten free diet or continue to wait until there is damage? I didn’t have this choice and thank goodness I never had to make it. My diagnosis story was pretty straight forward. I said I was sick. We did some tests. We confirmed I had celiac – done, easy peasy. Many people don’t have that straight forward luck and for them this diagnosis is much more elusive.
I want everyone to have a diagnosis if they truly have celiac. But I also want people who don’t have celiac don’t have to suffer under the gluten free diet with all of the trials and tribulations it brings. So, this is tough one.
Enjoy and have a great weekend.