Signs & Symptoms
Symptoms vary greatly from person to person and some people – especially those with associated conditions – have no symptoms at all. Many adults with celiac disease do not suffer from classic digestive symptoms. Instead, they may experience such symptoms as unexplained fatigue, mouth cankers or joint pain, making diagnosis all the more challenging. Not all affected individuals lose weight; in fact, about 30% are overweight. About 10% have a skin condition called dermatitis herpetiformis, an intensely itchy rash usually found on the elbows, knees and buttocks. It may appear initially as groups of blisters that form small red lesions from being scratched. In children, common additional symptoms include dental enamel defects, irritability, poor growth or failure to thrive, and delayed puberty.
Some people first come to their doctor’s attention because of unexplained lab test results such as a low red blood cell count (anemia) or elevated liver enzymes. In other cases, celiac disease is diagnosed when a patient undergoes an upper endoscopy for other reasons (e.g., gastroesophageal reflux disease). If you have celiac-type symptoms and have an upper endoscopy, ask your physician to obtain tissue to help diagnose (or rule out) celiac disease.
As shown below, symptoms extend beyond the gastrointestinal (GI) tract to all parts of the body and even the mind.
GI symptoms of celiac disease
- Abdominal pain
- Nausea and vomiting
- Gas, flatulence
- Diarrhea, foul-smelling stools
- Mouth ulcers
- Dental enamel abnormalities
- Lactose intolerance
Other bodily symptoms of celiac disease
- Unhealthy pale appearance
- Weight loss (though 30% of affected people are overweight)
- Fluid retention
- Bone and joint pain
- Muscle cramps, weakness and wasting
- Easy bruising
- Skin rash
- Infertility and recurrent miscarriages
- Poor growth, delayed puberty in children
- Perceptual/psychological symptoms
- General weakness and fatigue
- Tingling in legs and feet (from nerve damage)
- Persistent hunger (due to malnutrition)
- Vertigo (dizziness)
- Anxiety, depression
Alarm symptoms of celiac disease
Some alarm symptoms are not unique to celiac disease. These symptoms may signal other, possibly more serious health issues. Consult your doctor if you experience any of the following:
- Rectal bleeding with dark red blood mixed in with the stool
- Unintended weight loss
- Persistent diarrhea
- Abdominal pain that is not relieved by a bowel movement or that wakes you up at night.
Risks of Untreated Celiac Disease
If you have celiac disease, living a gluten-free life is imperative to your good health. Over a period of time, untreated celiac disease can lead to such medical problems as:
This means you’re unable to digest the milk sugar (lactose) found in dairy products. While not dangerous, lactose intolerance can lead to uncomfortable GI symptoms.
Celiac disease interferes with the absorption of bone-strengthening substances like calcium and vitamin D and may also damage bones directly.
If you’re malnourished, you feel weak and tired and you’re unable to recover properly from infections and injuries.
Such as type 1 diabetes and inflammation of the thyroid, joints, nerves or liver.
Untreated celiac disease slightly increases the risk of colon cancer and lymphoma (cancer of the lymphatic system). Whether or not you have celiac disease, it’s important to be aware of colon cancer symptoms, which include blood in stools, unexplained weight loss, and changes in bowel habits lasting more than 4 weeks.
Infertility and Miscarriages
There is evidence that implies that there may be a connection between recurring miscarriage, infertility, and autoimmune disorders. Pregnant women who may unknowingly have celiac disease are more likely to suffer a miscarriage. Additionally, they are at risk of developing anemia or going into preterm labor.
Failure to thrive, poor growth or delayed puberty (in children)
Currently, there is no definitive link. However many researchers attribute malnutrition, and malabsorption of important nutrients to the delay in puberty in children with undiagnosed celiac disease experience a delay in puberty and struggle to thrive and grow in the same way that healthy children do.
To reduce your chances of developing these complications, ensure you follow an entirely gluten-free diet for life. Multiple studies have shown that your risk of getting almost all these complications falls quickly to the risk in the general population – as long as you maintain a gluten-free diet. Remember that even tiny amounts of gluten can trigger symptoms that increase your risk of complications over time. As an example, as little as 1/60 of a slice of bread can cause intestinal injury.