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Traditionally, adults with celiac disease (CD) are thought to present with the classic symptoms of weight loss and steatorrhea (fecal matter that is frothy and foul-smelling and floats because of its high fat content). Recent epidemiologic studies, primarily in Europe, however, indicate that many patients do not present with these symptoms. A recent study of 1032 patients with CD in the United States, reported in Digestive Diseases and Sciences, confirmed these findings. The results showed that only 32% of respondents were underweight, and only 50% reported frequent diarrhea and weight loss. Common presenting symptoms included fatigue (82%), abdominal pain (77%), bloating or gas (73%), and anemia (63%). Initial physician diagnoses included irritable bowel syndrome (37%), psychological disorders (29%), and fibromyalgia (9%).
These results support those of other studies that have examined trends in the identification and clinical features of CD. They suggest that this disorder may not be as rare in the United States as it is currently considered to be.