It is estimated that as many as 1 in 133 people in the United States have celiac disease – that’s roughly 1% of the population. This condition affects both men and women of all ages, and it does not appear to affect one race or ethnicity over the other.
Despite how common the disease actually is, it is frequently misdiagnosed which leads patients to suffer for months or even years before they receive a correct diagnosis and make the switch to a gluten free diet.
The gluten free diet is the only 100% effective treatment for celiac disease because it is an autoimmune condition triggered solely by the consumption of gluten. Autoimmune diseases, in general, can be tricky to diagnose because the symptoms often overlap with other conditions or they are so obscure that they do not seem related – this is often the case with celiac disease.
If you have a family member with celiac disease, or if you are wondering whether you have the disease yourself, reviewing the most common symptoms for this condition may provide some initial clarity. Please keep in mind that this is not medical advice and if you are suspicious of having celiac disease, see a doctor as soon as possible.
While there are over 200 symptoms of celiac disease, we’ve narrowed down the most popular to help you identify and understand more about this complex disease. Keep reading to learn more…
The Top 10 Symptoms of Celiac Disease
Celiac disease is different from a food allergy, though some of the symptoms may overlap. It is triggered by the consumption of gluten which causes the body to launch an immune response against the proteins in gluten – gliadin and glutenin. In attacking these perceived threats, the immune system ends up damaging the lining of the small intestine which is what causes many of the most common symptoms.
Here is an in-depth look at the top 10 symptoms of celiac disease.
Celiac disease causes damage to the lining of the small intestine which may trigger digestive symptoms such as diarrhea. Many people notice loose, watery stools as the first symptom of celiac disease, though this symptom is easily attributed to other conditions and cannot be used to diagnose celiac disease in and of itself. In combination with other symptoms, however, chronic diarrhea is certainly relevant.
Several studies have identified diarrhea as one of the most common early signs of celiac disease. In one study published in the American Journal of Clinical Nutrition, diarrhea was the most commonly reported symptom of untreated celiac disease. In another study published in Gastroenterology, 79% of participants reported frequent diarrhea prior to receiving treatment and 17% continued to experience chronic diarrhea after treatment.
On the opposite end of the spectrum from diarrhea is constipation, another common symptom of celiac disease. When a person with celiac disease consumes gluten, the body launches an autoimmune attack, treating the proteins in gluten like foreign invaders. In attacking those proteins, the immune cells also mistakenly cause damage to the villi in the small intestine – the tiny finger-like projections that absorb nutrients from food passing through the digestive tract.
Unfortunately, when those villi become damaged, it can prevent the absorption of nutrients and may cause the villi to absorb moisture from passing stools instead. As a result, the stools become much harder and more difficult to pass – this results in constipation. Constipation can also be a factor when switching to a gluten free diet because cutting out gluten-containing grains could possibly result in a reduction of fiber intake.
3. Gas or Bloating
In addition to diarrhea and constipation, other digestive symptoms commonly linked to celiac disease include gas and bloating. The autoimmune activity that damages the small intestine can also cause inflammation which may result in bloating, among other digestive issues. In one study of over 1,000 participants, bloating was among the most commonly reported symptoms, affecting 73% of participants.
Another common symptom of undiagnosed celiac disease is frequent gas. One small study published in the Scandinavian Journal of Gastroenterology found that gas was one of the most common symptoms of celiac disease, along with diarrhea, headache, and nausea. Because gas can often be attributed to other conditions such as indigestion, lactose intolerance, or irritable bowel syndrome, it is sometimes misdiagnosed as such. It is important to pair this symptom with others to make an accurate diagnosis.
4. Changes in Weight
In the early stages of celiac disease when malnutrition becomes a factor, it is not uncommon for patients to drop a lot of weight or to have trouble keeping weight on. This is also a common symptom in children with undiagnosed celiac disease. According to one study published in the World Journal of Gastroenterology, weight loss was reported in 23% of celiac disease patients. The trouble is that weight loss can also be attributed to other conditions like diabetes, depression, cancer, or thyroid issues. As with gas and bloating, it is important to pair weight changes with symptoms to make an accurate diagnosis.
5. Chronic Fatigue
One of the more usual symptoms of undiagnosed celiac disease is decreased energy levels or fatigue. There are several factors related to celiac disease which contribute to this symptom. First and foremost, damage to the lining of the small intestine caused by celiac-related autoimmune activity prevents the body from absorbing nutrients the body needs to function properly on a daily basis. Second, iron-deficiency anemia may cause chronic fatigue as well.
According to one study published in the Journal of Clinical Gastroenterology, people with celiac disease experienced more severe fatigue and more fatigue-related problems than people who were following a gluten free diet. Another study forged a link between celiac disease-related sleep disorders which could also contribute to fatigue. In a way, it becomes a never-ending cycle where poor sleep causes fatigue which worsens other symptoms that contribute to poor sleep.
6. Depression or Anxiety
Many people fail to realize that some of the most common symptoms of undiagnosed celiac disease are not physical but mental. According to an analysis of 29 separate studies, depression is more common and more severe in adults with celiac disease than among the general population. While there are many potential causes for depression, another study of over 2,250 participants found that 39% of patients self-reported depressive symptoms, so it is not a symptom to be ignored.
7. Skin Rashes
While digestive symptoms are the most common early signs of celiac disease, some patients develop skin-related symptoms. In most cases, these symptoms take the form of an itchy, blistering skin rash on the elbows, knees, or buttocks – it is called dermatitis herpetiformis. Interestingly, many of the patients who have skin symptoms do not report digestive symptoms. In fact, one study showed that fewer than 10% of celiac disease patients who experienced skin problems caused by their condition reported any digestive symptoms.
8. Frequent Headaches
There is a two-way correlation between celiac disease and frequent headaches or migraines. According to one study, patients with celiac disease are likely to suffer from migraines and migraine sufferers are more likely to develop celiac disease. Researchers believe that this link is caused by increased intestinal permeability and inflammation. When the gut becomes leaky, inflammatory compounds enter the bloodstream and travel to the brain where they wreak all kinds of havoc.
Not only are frequent headaches or migraines a symptom of celiac disease, but they are also one of the more common symptoms people exhibit after accidentally consuming gluten while following a gluten free diet. In many cases, resuming a gluten free diet resolves the migraines.
9. Joint Pain
When someone with celiac disease consumes gluten, it causes an autoimmune reaction that triggers inflammation throughout the body, but particularly in the digestive tract. In some cases, that inflammation affects the joints. Even people with rheumatoid arthritis who do not suffer from celiac disease often find that reducing their gluten consumption improves symptoms.
10. Iron Deficiency Anemia
By now you know full well that celiac disease can lead to the malabsorption of nutrients, due to its attack on the villi within the stomach. One of the nutrients it causes a deficiency of is iron.
Iron is needed for your bone marrow to produce hemoglobin, a requirement for making red blood cells. Iron-deficiency anemia caused by celiac disease may produce symptoms of its own including weakness, fatigue, chest pain, headaches, and dizziness. In a study of children with celiac disease, 15% had mild to moderate iron-deficiency anemia.
While the symptoms described above are recognized as some of the most general and widespread when it comes to celiac disease, there are hundreds more to consider. Some of the more obscure and unknown symptoms include short stature, tooth decay, canker sores, and even infertility.
What To Do Next
Just because you experience one or two of the symptoms listed above doesn’t necessarily mean that you have celiac disease. If you are concerned about your symptoms, your first step should be to talk to your doctor about getting the necessary tests to make a diagnosis.
If it turns out that you do have celiac disease, you’ll need to follow a gluten free diet. Fortunately, that is becoming easier than ever with gluten free food companies like Schär offering safe and healthy gluten free food items.