Celiac disease and the athlete.

With the diagnosis of celiac disease rising in the past decade and with increased public awareness, team physicians are faced with both managing and diagnosing athletes with celiac disease. Sports medicine physicians need to recognize that celiac disease can present with a number of different symptoms and, therefore, should consider celiac disease as part of their differential in evaluating athletes with prolonged unexplained illnesses. Sports medicine physicians must be familiar with the appropriate laboratory tests and diagnostic procedures used to establish the diagnosis of celiac disease. A multidisciplinary approach in helping the newly diagnosed athlete with celiac disease is important to the successful treatment of the disease. Athletes with celiac disease often have problems with iron absorption (leading to anemia) and/or vitamin D and calcium absorption (leading to osteoporosis and poor bone health). Even athletes with known and long-standing celiac disease need additional care and supervision in ensuring there is no disruption in their gluten-free diet, which can lead to a flare-up of symptoms or a decrease in performance.