There are more than 300 symptoms of celiac disease. Symptoms may vary among different people.
While one individual may have diarrhea and abdominal pain, another person experiences irritability or depression. Some patients develop symptoms of celiac disease early in life, while others feel healthy far into adulthood.
Some people with celiac disease have no signs or symptoms at all. This is known as asymptomatic or “Silent” celiac disease. It is unclear why some people have symptoms while others do not. However, people without symptoms will still have intestinal damage if they ingest gluten, even if they do not get sick.
Common Gastrointestinal Symptoms
Abdominal Pain, Abdominal Bloating
Typically occurs after eating – Bloating can be associated with abnormal swelling of the abdomen. This results in the feeling of a full or tight abdomen and is often accompanied by discomfort and/or pain. Gas can also cause bloating. Celiac Disease and Non-Celiac Gluten Sensitivity (‘gluten sensitivity’) are just two of the many causes of these symptoms.
The sensation of feeling like you are going to vomit. This feeling can occur before one eats or after one eats. Typically, nausea is associated with distention of either the stomach and/or intestines. Although nausea is a non-specific symptom, patients with celiac disease or non-celiac gluten sensitivity can suffer from nausea symptoms.
Diarrhea or Fatty/Greasy Stools (Steatorrhea)
Diarrhea is the condition of having frequent loose or liquid bowel movements. This may be accompanied by cramping, abdominal pain, bloating, nausea or an urgent need to use the bathroom. Chronic diarrhea may be a symptom of a chronic disease. For someone with celiac disease, diarrhea is often caused by malabsorption, the inability to absorb nutrients from food.
Constipation is a condition of the digestive system where the stool is hard, difficult and painful to pass. The most common causes of constipation are poor diet and lack of exercise. Frequent constipation can be a symptom of a more serious problem or health issue and can be seen in patients with celiac disease.
Unexplained Weight Loss or Poor Weight Gain
The inability to gain or maintain weight may indicate an issue with nutrient absorption. Malnutrition, commonly seen in people with celiac disease, is one of the clinical markers that points to a diagnosis of celiac disease. Undiagnosed celiac cisease could explain poor weight gain in people who are maintaining a well-balanced diet.
Despite a well-balanced diet, deficiencies in fat soluble vitamins (A,D,E,K), Vitamin B12, Folic Acid and Iron can be seen in patients with celiac disease. Other minerals such as copper and zinc can also be malabsorbed.
Common Extra-Intestinal Symptoms
Anemia is a decrease of red blood cells in ones blood. In celiac disease patients anemia can be from deficiencies in iron, vitamin B12 or copper. Anemia is extremely common, especially in women who have their monthly menses. There are many potential causes of anemia, such as a lack of iron in the diet, blood loss, or absorption issues. People who have anemia may feel tired, fatigued, or weak.
Pale Oral Ulcers (Aphthous Ulcers)
Pale mouth sores (commonly referred to as canker sores) are caused by a break in the skin on the inside of the mouth. Various types of sores can appear anywhere within the mouth, including the inner cheeks, gums, base of the tongue, inner lips or palate. They can have many causes. Mouth sores can be a sign of a more serious medical condition, including celiac disease.
Rashes – Dermatitis Herpetiformis, Eczema
Dermatitis Herpetiformis (DH) is the skin manifestation of celiac disease. It is fairly common and is characterized by an intensely itchy, blistering rash that usually can be found primarily in clusters on elbows, back of forearms, knees, back, buttocks, back of neck and scalp. Whereas eczema is also an itchy rash that tends to be more red and scaly that typically involves the flexure areas of the skin near joints but can be seen on extensor surfaces and cheeks and scalp in infants and very young children. Eczema can be associated with both celiac disease and non-celiac gluten sensitivity.
The loss of monthly menstrual periods with women that is unrelated to pregnancy or nursing. This condition can be seen in women who have significant or rapid weight loss usually associated with malabsorption conditions such as celiac disease.
Brittle Bones or Premature Osteoporosis/Osteopenia
Thin bones or the thinning of bone tissue and loss of bone density over time. This occurs when enough new bone is not formed, when too much old bone is reabsorbed by the body or both. There are no symptoms in the early stages of the disease. Symptoms occurring late in the disease include bone pain or tenderness, fractures with little or no trauma, unexplained loss of height, lower back pain, neck pain and stooped posture. This can be a result of deficiencies in both calcium and vitamin D and can be associated with celiac disease.
Fatigue (tiredness) is a state of physical or mental weariness. Tiredness can be both a physical and mental symptom. Chronic tiredness can be a symptom of many different diseases or conditions, including autoimmune conditions such as celiac disease.
Joint Pain or Arthritis
Joint pain can be caused by many types of injuries or conditions. It can range from mild or serious discomfort to chronic pain that can decrease a person’s range of motion in a joint or limb. Some autoimmune diseases, such as celiac disease, can be associated with arthritis like pains.
Discolored Teeth or Dental Enamel Defects
Discolored teeth can be a symptom of celiac disease among other possible health issues. This symptom manifests as white, yellow or brown spots on the front and back teeth (incisors and molars). Tooth defects resulting from celiac disease are permanent and do not improve once a diagnosed person adopts a gluten-free diet.
Failure to Thrive or Grow (Pediatric Population)
A slow rate of growth is defined as poor or abnormally slow height or weight gains, more specifically in children. Many children with delayed growth also have delays in mental development. This often occurs in children who have celiac disease as a result of malabsorption, the failure to properly absorb necessary nutrition and provide the body with its needed nutrients for development.
Common Neurological Symptoms
The most common neurological symptoms are loss of balance (lack of coordination, clumsiness, instability when walking, tendency to fall, slurred speech), sensory symptoms (numbness, tingling usually affecting feet and hands), headaches that do not respond to the usual medication. More serious neurologic symptoms would be seizures, and ataxia (gait disturbances).
Headaches are a symptom of a number of different conditions of the head and sometimes neck. It is among the most common pain complaints of people living with undiagnosed celiac disease. Like other types of pain, headaches can serve as warning signals of more serious disorders. If headaches occur more frequently during the month, you should seek a doctor or medical professional for assistance immediately.
Depression refers to a feeling of being sad, helpless and hopeless. Some symptoms of depression are anxious or empty moods, feeling hopeless, feelings of guilt, feelings of worthlessness and a loss of interest in activities that were once enjoyed. Health conditions such as celiac disease are among the biological influences that can cause depression.
Numbness of Extremities or Peripheral Neuropathy
Tingling or numbness are abnormal sensations that can occur anywhere in your body. It is a sensation of tingling, prickling, or numbness of a person’s skin with no apparent long-term physical effect. It can also be described as “pins and needles” or referred to as a limb being “asleep.” Due to malabsorption of certain B complex vitamins such as vitamin B12 or vitamin E.
Common Related Conditions
An autoimmune condition that is a common cause of hypothyroidism in which the body mounts an immune reaction against its own thyroid gland tissue, leading to inflammation of the gland.
Also known as toxic diffuse goiter, is an autoimmune disease that often results in an enlarged thyroid. It is the most common cause of hyperthyroidism.
Also known as primary adrenal insufficiency and hypocortisolism, is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones.
Type 1 Diabetes
An autoimmune condition in which the immune system is activated to destroy the cells in the pancreas which produce insulin. Also known as juvenile diabetes or diabetes mellitus type 1. Celiac disease is more common in people with type 1 diabetes. An estimated 10% of people with type 1 diabetes also have celiac in contrast to the 1% rate of celiac disease among the general population. Additional Information
An autoimmune disease that causes chronic inflammation of the joints and other areas of the body.
Irritable Bowel Syndrome (IBS)
A common chronic condtion that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both
A type of inflammatory bowel disease (IBD) that may affect any part of the gastrointestinal tract from mouth to anus.
Studies in the 1990s indicate that 7-16% of children with Down syndrome have Celiac disease. Additional Information
Studies have found that 4-6% of Turner syndrome patients also have celiac disease. Additional Information
Unexplained Male or Female Infertility
Abnormally Elevated Liver Enzyme Levels
What Does It Mean If I Have Some Of The Symptoms?
If you have even one of these conditions, it would be a good idea to bring that to your doctor’s attention and discuss having the screening blood tests for celiac disease. If you have multiple conditions, consider having the screening tests as soon as possible.
The treatment for celiac disease or gluten intolerance is to remove gluten from the diet. However, celiac specialists recommend that you do not exclude gluten before you are tested as this will lower the chances of getting accurate results. Therefore it is important NOT to remove gluten from the diet before testing is done. Note that the first step to diagnosing non-celiac gluten sensitivity is also to undergo celiac blood screening tests.