Gluten hypersensitivity

What is gluten hypersensitivity?

Gluten hypersensitivity (coeliac disease) is a condition that may be seen in people with a genetic susceptibility who suffer from problems in the small intestine after eating gluten. Organs other than the small intestine may also be affected.

What are the complaints associated with gluten hypersensitivity?

The following symptoms may be seen: diarrhoea, weight loss, delayed growth (in children), vomiting, abdominal pain, swollen stomach (with or without rumbling), anorexia and hard stools/constipation. Overweight does not exclude the diagnosis.

In addition, there may be symptoms involving other organs: dermatitis herpetiformis (intense itchy and red skin on the arms and legs), anaemia due to iron deficiency, elevated levels of liver enzymes in blood, short posture, fatigue, vitamin deficiency, malnutrition, regularly-recurring information of the membranes of the mouth and dental enamel defects.
Gluten hypersensitivity may also be associated with auto-immune diseases, examples being thyroid conditions and diabetes mellitus type 1. In addition, a variety of neuropsychiatric conditions have been reported in people with gluten hypersensitivity, such as depression, anxiety, peripheral neuropathy (a nerve condition), ataxia (a locomotive condition), epilepsy and migraine. ³¹⁶

People with intellectual disabilities sometimes find it impossible to communicate these symptoms. The people around them may then notice only a change in behaviour.

How common is gluten hypersensitivity in the general population? ³¹⁶

In adults, the prevalence rates are 0.016% for diagnosed coeliac disease and 0.35% for non-diagnosed coeliac disease. In children, the incidence rate for diagnosed coeliac disease is 0.054% and the prevalence rate is 0.51% for non-diagnosed coeliac disease. ³¹⁶

How common is gluten hypersensitivity in people with intellectual disabilities?

It is not known how common coeliac disease is in the total population of people with intellectual disabilities.

A study of children with intellectual disabilities in whom the syndrome had not been diagnosed found that they were just as likely to have coeliac disease (5.5%) as the healthy children in the control group. ⁵⁶⁵

People with Down syndrome are more likely to have coeliac disease ^{566   567} : the prevalence rate in the Netherlands is 8% ³¹⁶ .

A Portuguese study of 98 children and adults with Down syndrome found a prevalence rate of 9.2%. ³¹⁷

People with Down syndrome and coeliac disease often have a history of gastrointestinal complaints such as chronic diarrhoea and delayed growth but one third of them have no symptoms. Coeliac disease can occur at an early age but also over time.

Higher prevalences of coeliac disease are also found in conjunction with Turner syndrome (4% ³¹⁶  to 9.5% ⁵⁶⁸ ) and Williams syndrome (2.2% ⁵⁶⁸ to 8% ³¹⁶ ).