Different types of coeliac disease

This most typical form of coeliac disease tends to present itself early in life, with patients showing symptoms connected to malabsorption of nutrients such as chronic diarrhoea, weight and energy loss, lack of appetite, sickness and bloating. In children it may also manifest itself in a lack of growth or delayed puberty. 

Patients may have mild gastrointestinal symptoms without clear signs of malabsorption, or they may have seemingly unrelated symptoms. They may suffer from abdominal bloating and pain, and/or some of a wide range of other symptoms including: iron-deficiency anaemia, chronic fatigue, chronic migraine, peripheral neuropathy (tingling, numbness or pain in hands or feet), unexplained chronic hypertransaminasemia (elevated liver enzymes), reduced bone mass and bone fractures, and vitamin and mineral deficiency (including vitamin B12 and calcium, late menarche/early menopause and unexplained infertility, dental enamel defects, irritability and dermatitis herpetiformis, an itchy skin rash.

 Also called subclinical coeliac disease, patients are not severely affected by any of the symptoms that could alert them to the fact that they have the condition, but they are suffering from the related damage to their small intestine. Studies show that even though patients thought they had no symptoms, after going on a strict gluten free diet they report better health and a reduction in acid reflux, abdominal bloating and flatulence. 

Potential coeliac disease is when the biopsy test on the intestine is inconclusive, but typical antibodies associated with coeliac disease are found in the blood. According to a study carried out in Italy, most patients (79%) with potential coeliac disease were symptomatic. Of these 61 people with symptoms, 10 had diarrhoea and weight loss, while 51 had non-classic symptoms including at least one of the following: iron deficiency, folate deficiency, osteopenia (low bone mass), mouth ulcers, irritable bowel syndrome (IBS), reflux, elevated transaminase levels and recurrent miscarriages.