Celiac disease is an autoimmune disorder that affects around 1 in 100 people worldwide. When someone with celiac disease eats gluten, it triggers an immune response that attacks the small intestine and causes damage and inflammation. This can lead to a variety of symptoms and complications.
There are 4 main symptoms of celiac disease that people often experience:
1. Diarrhea
One of the most common symptoms of celiac disease is chronic diarrhea. This occurs when the damaged villi in the small intestine are unable to properly absorb nutrients from food. As a result, excess water and nutrients end up passing through the intestine and lead to frequent, watery bowel movements.
Diarrhea from celiac disease can range from mild and occasional to severe and constant. It may alternate between constipation and diarrhea. Some people notice changes immediately after eating gluten, while for others it can take hours or even days for diarrhea to develop after a gluten exposure.
Over time, the ongoing inflammation and malnutrition caused by celiac-related diarrhea can lead to weight loss and other complications. Seeking treatment with a gluten-free diet helps restore the intestine’s ability to absorb nutrients and resolve the diarrhea in most cases.
2. Abdominal Pain
Many people with celiac disease experience recurrent abdominal pain, especially in the lower abdomen. There are several reasons why this occurs:
- Inflammation from the autoimmune attack on the small intestine can cause pain and cramping.
- Nutrient malabsorption leads to gas and bloating.
- The changes to digestion cause abdominal discomfort after eating.
- In rare cases, celiac disease causes stomach ulcers which are painful.
The abdominal pain may be described as cramping, aching, or soreness. It can range from mild to debilitating. The pain may start minutes to hours after gluten is consumed. For some celiac patients, the abdominal pain is severe enough to be confused with appendicitis or other serious medical issues before celiac is diagnosed.
3. Bloating
Bloating and gas are very common with celiac disease due to the body’s inability to properly absorb nutrients. When food is not broken down and absorbed correctly, it sits in the intestines and ferments, producing excess gas that leads to bloating and flatulence.
Many people with celiac disease report abdominal bloating and distention after meals, especially when they eat foods with gluten. Bloating may be accompanied by visible stomach distention, passing gas, belching, cramps, and general discomfort.
While anyone can experience occasional bloating when they eat foods that upset their digestive system, the bloating from celiac disease tends to be more chronic and persistent until gluten is removed from the diet. Taking over-the-counter gas medications or probiotics may help somewhat, but avoiding gluten is the key to resolving the bloating.
4. Fatigue
Fatigue and tiredness are very common in people with untreated celiac disease. There are several explanations for celiac-related fatigue:
- Nutrient malabsorption leads to vitamin and mineral deficiencies that disrupt energy production.
- The immune attack on the body is physiologically taxing.
- Untreated celiac disease can lead to anemia which reduces oxygen circulation.
- Diarrhea and abdominal discomfort make sleep difficult.
The fatigue associated with celiac disease can range from mild to completely debilitating. People may feel too exhausted to perform daily activities or constantly need to rest. Interestingly, celiac fatigue is not necessarily correlated with weight loss – some patients have normal BMIs but struggle terribly with fatigue.
The good news is that once celiac is treated with a strict gluten-free diet, fatigue often resolves within weeks to months as the intestine heals. Proper nutrient absorption returns and inflammation resolves. Some patients notice a marked increase in their energy levels almost immediately after going gluten-free.
Other Common Symptoms
In addition to the 4 main symptoms above, there are several other common signs and symptoms of celiac disease to know:
- Weight loss – celiac malnutrition often leads to lower body weight, especially in children.
- Joint pain – some research links celiac disease to arthritis and joint issues.
- Headaches – headaches are more common in people later diagnosed with celiac disease.
- Skin rash – celiac disease can cause an itchy skin rash called dermatitis herpetiformis.
- Tingling numbness – nerve damage from celiac disease can cause tingling and numbness in the legs and arms.
- Tooth discoloration – in children, celiac disease can impact tooth enamel leading to discolored teeth.
Keep in mind that celiac disease symptoms vary tremendously from person to person. Some patients experience mild or atypical symptoms, while others develop the severe “classic” version of the disease. There is also overlap between celiac disease and other conditions like IBS, fibromyalgia, chronic fatigue syndrome, and thyroid disorders.
Why Does Celiac Disease Cause These Symptoms?
The wide range of celiac disease symptoms stem from the underlying autoimmune attack on the small intestine when gluten is present. Here’s a breakdown of how celiac disease leads to common symptoms:
- Diarrhea – Damaged villi in the small intestine cannot absorb water and nutrients properly, leading to watery diarrhea.
- Abdominal pain – Inflammation and intestinal injury causes cramping and pain.
- Bloating – Poor nutrient absorption means undigested food sits in the intestine, causing gas.
- Fatigue – Malabsorption of carbs, fat, protein, vitamins and minerals disrupts bodily energy.
- Joint pain – Increased immune activity may play a role in pain and arthritis.
- Rashes – Celiac antibodies cluster in the skin, causing irritation.
- Headaches – Severeintestinal inflammation may impact headaches.
- Tingling – Nerve compression from vitamin deficiencies causes numbness.
- Tooth issues – Nutrient deficiencies affect tooth enamel development.
This also explains why celiac symptoms start improving for most patients once they remove gluten from their diet. When gluten is no longer consumed, the immune system stops attacking the intestine, allowing villi to heal and digestive function to return.
Celiac Disease Symptom Checker
Wondering if your symptoms may indicate celiac disease? This celiac symptom checker covers the most common signs:
| Celiac Symptom | Description |
|---|---|
| Diarrhea | Frequent loose, watery bowel movements. May alternate between diarrhea and constipation. |
| Bloating | Abdominal swelling or feeling of fullness, especially after eating. |
| Abdominal Pain | Cramping, aching feeling in the stomach that may occur after eating. |
| Fatigue | Ongoing tiredness, lack of energy, feeling run down. |
| Joint Pain | Discomfort, swelling, or stiffness in the joints. |
| Headaches | Frequent headaches or migraines. |
| Skin Rash | Itchy red bumps on elbows, knees, back or buttocks. |
| Tingling Numbness | Pins and needles feeling or loss of sensation in arms and legs. |
| Tooth Discoloration | In children, yellow, stained, or pitted teeth. |
| Weight Loss | Lower body weight than expected or rapid unexplained weight loss. |
Keep in mind many conditions can cause these symptoms, but if you are experiencing several of them, it may be worth getting tested for celiac disease. Let your doctor know if any symptoms started after eating gluten-containing foods.
When to See a Doctor
If you are experiencing potential celiac symptoms, it’s important to see a doctor, especially a gastroenterologist. Getting an accurate diagnosis for celiac disease requires blood tests and endoscopy biopsy of the small intestine.
It’s not recommended to attempt a gluten-free diet until completing the celiac testing first, as removing gluten can impact the accuracy of results. The exception is for people with severe celiac symptoms that are significantly disrupting quality of life.
A few reasons to prioritize seeing a doctor for possible celiac symptoms include:
- Persistent diarrhea lasting more than 2 weeks
- Frequent abdominal pain and vomiting
- Unintentional weight loss
- Blood in stool
- Bloating or pain that wakes you up at night
- Family history of celiac disease
Additionally, adults and children with anemia, chronic fatigue, osteoporosis, abnormal liver enzymes, infertility, miscarriages, or other unexplained symptoms should be evaluated for celiac disease. Celiac can develop at any age.
Getting an accurate diagnosis and starting treatment can help prevent serious long-term complications of celiac disease like malnutrition, osteoporosis, infertility, neurological conditions, and in rare cases, small intestine cancers. Continued exposure to gluten also increases the risk of other autoimmune diseases developing.
How Are Celiac Disease Symptoms Treated?
The treatment for celiac disease symptoms is to follow a strict gluten-free diet for life. Gluten is a protein found in wheat, barley, and rye. It’s commonly found in bread, pasta, baked goods, cereals, seasonings, beer, and processed foods.
Once all sources of gluten are removed from the diet, the immune system reaction subsides and the intestinal villi start healing. This allows symptoms like diarrhea, abdominal pain, and bloating to resolve over time. Nutrient absorption returns to support energy levels and overall health.
For most patients, adherence to a gluten-free diet also means celiac antibodies in the blood return to normal levels, confirming the autoimmune attack on the body has stopped. Strict food avoidance for life is necessary as even small traces of gluten can trigger symptoms and intestinal damage.
In addition to the dietary change, doctors may recommend supplements to help correct nutrient deficiencies that have developed. Medications or immune modulators may be prescribed in some cases to help control celiac symptoms. Counseling with a dietitian can help educate on safe gluten-free foods.
Conclusion
Celiac disease is an autoimmune disorder where gluten damages the small intestine. This causes a variety of digestive and malabsorption symptoms. The main symptoms of celiac disease include diarrhea, abdominal pain, bloating, and fatigue. Identifying celiac is important to allow prompt treatment with a gluten-free diet and reduce the risk of complications.
If you are experiencing any concerning digestive symptoms, significant fatigue, or other health issues, don’t hesitate to see a doctor. Blood tests and an intestinal biopsy can provide an accurate celiac disease diagnosis to get you on the path to feeling better.