Symptoms of Celiac Disease

The best-known (but not necessarily most common) symptoms of celiac disease include smelly diarrhea, abdominal pain, weight loss, and fatigue. However, celiac disease can affect just about every system in your body, including your skin, your hormones, and your bones and joints. It can cause symptoms you might never think to associate with the condition.

It's doubtful that there's a truly typical case of celiac disease; the condition can affect too many body systems for any one set of symptoms to be considered typical. Women, men, babies, and children are likely to experience celiac disease in quite divergent ways. And sometimes, you might have full-blown celiac but not have any symptoms at all.

Frequent Symptoms

The symptoms will vary considerably from person to person, and are also significantly different for children and for adults.

Adults

Adult digestive symptoms may include:

  • Diarrhea
  • Constipation
  • Heartburn
  • Bloating
  • Flatulence
  • Nausea and vomiting
  • Weight loss
  • Abdominal pain

Over half of adults have non-digestive symptoms, which may include:

  • Iron-deficiency anemia
  • Fatigue
  • Bone or joint pain, arthritis
  • Bone loss
  • Itchy skin rash with blisters (dermatitis herpetiformis)
  • Mouth ulcers
  • Headaches
  • Peripheral neuropathy with numbness or tingling in the feet and hands
  • Anxiety or depression
  • Irregular menstrual cycle, infertility

Children

Celiac disease usually has digestive symptoms in children and infants. The most common symptoms are:

  • Abdominal bloating and pain
  • Chronic diarrhea
  • Vomiting
  • Constipation
  • Stool that is pale, foul-smelling, or fatty (floating)
  • Weight loss
  • Fatigue
  • Mood changes, irritability
  • Damage to dental enamel of the permanent teeth
  • Slowed growth, short height, delayed puberty
  • failure to thrive
  • Attention deficit hyperactivity disorder (ADHD)

Here's a breakdown of celiac disease symptoms and related conditions, categorized by the body system they affect.

Digestive Symptoms

Not everyone who's diagnosed with celiac disease experiences digestive symptoms, but many do. For example, one study found such symptoms in about three-quarters of people who had just been diagnosed with the condition. Still, these digestive symptoms can be subtle, and you might not necessarily associate them with celiac disease.

Chronic diarrhea is one hallmark symptom of celiac disease, and it appears to affect half or more of those newly diagnosed. Frequently, the diarrhea is watery, smelly, and voluminous, and floats rather than sinks.

However, plenty of people with celiac disease tend to have constipation rather than diarrhea, and some see their symptoms alternate between the two.

Digestive symptoms can include diarrhea, constipation, heartburn, bloating, flatulence, nausea and even vomiting in certain circumstances. People with celiac disease often are diagnosed with irritable bowel syndrome.

In addition, other types of digestive symptoms can appear. For example, flatulence and excessive gas are common, as is abdominal bloating (many people describe themselves as looking "six months pregnant"). It's also common to have abdominal pain, which can be severe at times.

Additional digestive symptoms of celiac disease can include heartburn and reflux (some people already have been told they have gastroesophageal reflux disease, or GERD), nausea and vomiting, and lactose intolerance. Undiagnosed celiacs sometimes develop pancreatitis or gallbladder disease, and many already have been diagnosed with irritable bowel syndrome (those IBS symptoms often lessen or disappear completely following a celiac disease diagnosis).

In addition, not everyone loses weight as an undiagnosed celiac. In fact, many people find they gain weight prior to diagnosis. Some people report being absolutely unable to shed excess pounds, no matter how much they diet and exercise.

Neurological Symptoms

Many people with undiagnosed celiac experience extreme fatigue that prevents them from performing everyday tasks and impacts their quality of life. Generally, fatigue seems to creep up on you, making it easy to blame it on getting older (as opposed to a treatable medical condition).

At the same time, insomnia and other sleep disorders are very common in people with celiac. It's the worst of both worlds: You're exhausted during the day but can't fall asleep or stay asleep at night.

It's not uncommon for people with celiac disease to experience headaches (including migraines), brain fog, fatigue, and insomnia. They also may have pins and needles in their hands and feet, feelings of dizziness, and depression and anxiety.

In addition, many people with celiac disease get "brain fog" due to gluten. When you have brain fog, you have trouble thinking clearly—it literally feels as if your brain is operating in a fog. You might have trouble coming up with the right words to carry on an intelligent conversation, or you might misplace your car keys or fumble other common household tasks.

Some newly diagnosed celiacs already have diagnoses of migraine headaches; in many cases (but not all), these headaches will lessen in severity and frequency or even clear up completely once you adopt a gluten-free diet.

Psychological symptoms such as depression, anxiety, attention-deficit hyperactivity disorder, and irritability occur frequently in people with undiagnosed celiac disease. In fact, long-diagnosed celiacs often can tell they've been exposed to gluten through their irritability—that symptom can appear within hours of exposure and linger for several days. In small children with celiac disease, sometimes irritability is the only symptom.

Peripheral neuropathy, in which you experience numbness, a sensation of pins and needles, and potentially weakness in your extremities, is one of the most frequently reported neurological symptoms of celiac disease. In addition, some people are diagnosed with gluten ataxia, which is brain damage characterized by the loss of balance and coordination that's due to gluten consumption.

Restless leg syndrome has been reported as a common symptom of celiac disease.

Skin Disorders

You might see signs of celiac disease in your largest organ: your skin. Up to one-fourth of people with celiac suffer from dermatitis herpetiformis (a.k.a. "the gluten rash"), an intensely itchy skin rash. If you have dermatitis herpetiformis plus positive celiac blood tests, you have celiac disease—no further testing required.

dermatitis herpetiformis on legs and feet
BallenaBlanca via Creative Commons

People with celiac disease also may have a variety of other skin problems, including psoriasis, eczema, alopecia areata (an autoimmune condition where you lose your hair), hives, and even such common problems as acne and dry skin. There's no firm evidence that gluten ingestion causes or contributes to these skin problems, but the gluten-free diet helps clear them up in some cases.

Bone and Joint Symptoms

Bone and joint issues such as osteoporosis, joint pain, bone pain, rheumatoid arthritis, and fibromyalgia also occur with regularity in those with celiac disease. It's not clear what the connection is; it may involve nutritional deficiencies related to the fact that celiac causes intestinal damage, which makes it difficult for you to absorb vitamins and minerals. In some cases, the gluten-free diet can alleviate pain from these conditions.

Dental Issues

People with celiac disease often have terrible teeth and problematic gums. In adults with undiagnosed celiac disease, frequent cavities, eroding enamel, and other recurring dental problems can signal the condition. Children with undiagnosed celiac might have spots on their new teeth with no enamel, delayed eruption of their teeth (either baby or adult), and multiple cavities.

Canker sores (also known as aphthous ulcers) occur in both adults and children with undiagnosed celiac disease (and in those already diagnosed who ingest gluten accidentally). These painful mouth sores frequently crop up on the inside of your lips in areas where you've had a very minor injury (such as a scratch from a sharp piece of food, a utensil, or your teeth). Once they start, they can take up to a week to subside.

It's also not unusual to find celiac disease in a person who has periodontal disease or badly receding gums. In some cases, the gluten-free diet can help to reverse some of the damage that's been done.

Rare Symptoms

You can find lists of over 200 different symptoms of celiac disease. It's actually very common to experience marked improvement in other, minor ailments you never would have imagined were related to celiac disease when you adopt a gluten-free lifestyle.

It is now rare that children present with severe symptoms. These include chronic fatigue, very low blood pressure, electrolyte imbalances due to fluid loss in diarrhea, and abdominal obstruction.

In very unusual adult cases, the first obvious sign that a patient has unrecognized celiac is the frightening diagnosis non-Hodgkin lymphoma. Fortunately, this type of cancer is very rare, even in people who have had celiac symptoms for years but remained undiagnosed.

Complications/Sub-Group Indications

People with celiac disease are at risk of developing malnutrition. You are unable to absorb enough nutrients due to the damage to your digestive tract. This can result in anemia and weight loss.

Children with undiagnosed celiac disease often fall behind the growth curve, and this delayed growth or "failure to thrive" may be the only symptom of celiac disease in a child. If the child gets diagnosed prior to puberty and begins a strict gluten-free diet, she often can make up some or all of the height. Adults with longstanding undiagnosed celiac disease often are quite short.

Osteoporosis, in which your bones become thin and weak, frequently appears in concert with celiac disease. When you have celiac you can't absorb the nutrients needed to keep your bones strong.

Celiac disease can affect your hormones and other functions of your endocrine system, which controls everything from your reproductive system to your moods. In fact, celiac disease is found in 2 to 5 percent of patients with either thyroid disease or type 1 diabetes, and also appears frequently in patients with Sjogren's syndrome (an autoimmune condition in which your mouth and eyes become extremely dry).

Patients with Addison's disease (when your adrenal glands fail to produce enough of two essential hormones), hypophysitis (inflammation of your pituitary gland), or multiple endocrine diseases all carry a higher risk for celiac disease.

Reproductive health issues, including infertility in both women and men, skipped periods, late puberty, and early menopause also can signal the possibility of celiac disease (although, again, there are other potential reasons for these symptoms). Women with celiac are significantly more likely than other women to experience pregnancy problems and repeated miscarriages.

Celiac disease has differing effects on cancer risk. It may lower your risk of breast cancer, but raises the risk of cancer of the small intestine (a rare type of cancer), carcinoid tumors (a rare, slow-growing type of cancer that can occur in the digestive tract), and gastrointestinal stromal tumors (another rare form of cancer). It's not clear whether people with celiac disease have an increased risk for colon cancer.

When to See a Doctor/Go to the Hospital

See your doctor if you or your child has had diarrhea or digestive discomfort for two weeks or more. You should see your doctor before you try a gluten-free diet as that can change the test results.

All first-degree family members (parents, siblings, and children) of people diagnosed with celiac disease should be tested, as their risks increase to a 1 in 10 chance, even for those with no symptoms.

Celiac disease can masquerade as many, many other conditions. However, just because you have any of these symptoms (or even lots of them), it doesn't mean you necessarily have celiac disease—it just means you should consider being tested for the condition.

A Word From Verywell

Once you're diagnosed with celiac disease, it's for life. To avert long-term complications (including those cancers linked to celiac disease), you must follow a strict gluten-free diet. However, you'll probably be pretty happy to learn that following a strict gluten-free diet generally resolves most or all of your symptoms. You may even notice many minor health complaints disappearing once you're diagnosed and on the gluten-free diet.

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