Signs and Symptoms of Celiac Disease

Celiac disease is a long-term autoimmune condition that occurs when gluten—a protein found in wheat, barley, and rye—triggers an immune response. This response damages the small intestine, impairing its ability to absorb nutrients from food.

Diagnosing celiac disease can be challenging, as symptoms vary widely. Some individuals develop the condition in childhood, while others don’t show signs until adulthood. People may experience different symptoms depending on their age, and some may have no noticeable symptoms at all.

Symptoms can affect both the digestive system and other parts of the body. Common digestive symptoms include bloating, gas, constipation, and abdominal discomfort. Other symptoms might involve fatigue, joint or bone pain, anxiety, or changes in menstrual cycles.

The frequency and intensity of symptoms can differ between individuals and may fluctuate over time. However, once a gluten-free diet is adopted, many symptoms tend to improve or even resolve entirely.

Note: Celiac disease is associated with more than 200 potential symptoms.

Digestive Symptoms

While digestive issues are more common in children, people of any age may experience the following symptoms.

Bloating
A sensation of fullness or swelling in the abdominal area, often accompanied by discomfort.

Diarrhea
Loose, watery stools may occur. In children, this can be chronic, meaning it happens multiple times a day over several weeks.

Constipation
Defined as fewer than two bowel movements per week. Stools may also be hard, dry, or painful to pass.

Gas
The buildup of gas in the digestive tract can lead to belching or flatulence.

Steatorrhea
This refers to stools that are unusually fatty, pale, and foul-smelling, often indicating poor nutrient absorption.

Nausea or Vomiting
A queasy sensation or the urge to vomit can be a sign of digestive distress.

Abdominal Pain
Pain or cramping in the midsection, between the chest and hips, may be persistent or occur after eating.

Mood Symptoms

Celiac disease can impact emotional health, especially in both children and adults.

Depression
Characterized by persistent sadness, irritability, and a lack of interest in usual activities. To be diagnosed, these mood changes must last for at least two weeks.

Anxiety
Marked by constant worry, nervousness, and restlessness. Fatigue and irritability may also be present.

Children may exhibit increased irritability, impatience, and sensitivity as mood-related symptoms of the disease.

Skin Symptoms

Celiac disease may cause changes to the skin, particularly in individuals who remain untreated.

Dermatitis Herpetiformis
An intensely itchy, blistering skin rash that appears on the elbows, knees, buttocks, back, or scalp. This condition affects a notable percentage of people with untreated celiac disease.

Oral Symptoms

Some individuals may experience symptoms in the mouth that signal celiac disease.

Canker Sores
Small, painful ulcers that develop inside the mouth, commonly on the cheeks, under the tongue, or at the back of the throat.

Other Oral Changes
These may include a dry mouth and a tongue that appears red, smooth, and shiny.

Nervous System Symptoms

Celiac disease can present with neurological symptoms that affect both children and adults.

Headaches
Pain or pressure in the head, which may range from mild discomfort to severe migraines.

Seizures
Sudden episodes of uncontrolled movements, including muscle spasms, altered emotions, or loss of awareness.

Peripheral Neuropathy
This condition involves nerve damage, leading to tingling, numbness, or weakness in the hands, feet, or limbs. Though more common in adults, it can occasionally affect children.

Reproductive Symptoms

Celiac disease can influence reproductive health in both men and women.

Infertility
Difficulty conceiving or contributing to pregnancy, even after trying for a year or more.

Recurrent Miscarriages
Some women may experience repeated pregnancy loss as a result of untreated celiac disease.

Menstrual Irregularities
Girls and women may miss periods or experience delayed onset of menstruation.

Blood Symptoms

Anemia is a common complication in people with celiac disease.

Anemia
This condition occurs when the body doesn’t produce enough healthy red blood cells, leading to fatigue, weakness, and reduced endurance.

Types of Celiac Disease

Celiac disease can be grouped into three main types depending on symptoms:

Classical Celiac Disease
Involves clear signs of malabsorption, such as diarrhea or fatty stools, along with other nutritional deficiencies.

Non-Classical Celiac Disease
Presents with subtle or non-digestive symptoms like mood issues, fatigue, or skin rashes, without obvious signs of malabsorption.

Silent Celiac Disease
Shows no external symptoms but still causes internal damage to the small intestine.

Symptoms in Children

Children with celiac disease often show different signs due to disrupted growth and development.

Delayed Puberty
Children may not show typical signs of puberty at the expected age.

Poor Weight Gain
Inability to gain weight normally despite eating regularly.

Weight Loss
Unintended weight loss or difficulty maintaining a healthy weight.

Slowed Growth
Children may grow at a slower rate compared to peers.

Short Stature
Height may be below average for the child’s age.

Tooth Enamel Defects
Visible damage or discoloration on the surface of permanent teeth.

When To See a Healthcare Provider

Most individuals with celiac disease experience symptoms before they are diagnosed. If you notice recurring or unexplained symptoms—especially those related to digestion, mood, or energy levels—it’s important to consult a healthcare provider.

Diagnosis cannot be based on symptoms alone, since celiac disease shares similarities with other conditions. A provider will likely conduct a physical exam, review your medical history, and ask about any family history of autoimmune diseases. Blood tests and small intestine biopsies may also be necessary to confirm a diagnosis.

Even if you don’t have symptoms, it’s recommended to get tested if you have a first-degree relative with celiac disease, as the condition tends to run in families.

For children, regular check-ups are essential to monitor development and oral health. If you observe signs that your child is not growing as expected or shows symptoms like fatigue or digestive discomfort, a medical evaluation is advised.

A Quick Review

Celiac disease is a chronic autoimmune disorder triggered by gluten, leading to damage in the small intestine. Its symptoms are varied and may affect different systems in the body. While digestive symptoms are more common in children, adults may experience mood issues, reproductive challenges, or neurological symptoms.

Because of its complexity and symptom overlap with other conditions, celiac disease can be difficult to diagnose. However, identifying and treating the disease with a strict gluten-free diet can prevent long-term complications and significantly improve quality of life.