What are the common signs and symptoms of celiac disease (CD)?

From the Guidelines

Common signs and symptoms of celiac disease include gastrointestinal symptoms, such as diarrhea, nausea, vomiting, and abdominal pain, as well as extraintestinal symptoms like fatigue and weight loss. According to the most recent study 1, these symptoms result from the immune system's reaction to gluten, which damages the small intestine's lining and prevents proper nutrient absorption. The severity and combination of symptoms vary widely between individuals, with some people experiencing severe manifestations while others have minimal or no obvious symptoms despite intestinal damage.

Key Symptoms

• Gastrointestinal symptoms:
  • Diarrhea
  • Nausea
  • Vomiting
  • Abdominal pain
• Extraintestinal symptoms:
  • Fatigue
  • Weight loss
  • Iron-deficiency anemia
  • Dermatitis herpetiformis (an itchy skin rash)
  • Headaches
  • Joint pain
  • Neurological problems like numbness or tingling in the hands and feet

Special Considerations

Children with celiac disease may show delayed growth, short stature, delayed puberty, and dental enamel defects. Some people experience constipation rather than diarrhea. Mood changes, including anxiety and depression, can also occur. Symptoms typically improve when gluten is removed from the diet, which is the primary treatment for celiac disease, as supported by studies 1 and 1.

From the Research

Common Signs and Symptoms of Celiac Disease

• Typical gastrointestinal symptoms:
  • Diarrhea 2, 3
  • Steatorrhea 2
  • Weight loss 2, 3
  • Bloating 2, 3
  • Flatulence 2
  • Abdominal pain 2, 3
• Non-gastrointestinal abnormalities:
  • Abnormal liver function tests 2
  • Iron deficiency anemia 2, 4, 3, 5
  • Bone disease 2, 4
  • Skin disorders 2
  • Osteoporosis 3
  • Transaminitis 3
  • Recurrent miscarriage 3
• Many individuals with celiac disease may have no symptoms at all 2
• Non-classic symptoms, including less specific gastrointestinal symptoms or extraintestinal manifestations, are common in adult patients 3

Nutritional Imbalances and Deficiencies

• Deficiencies of iron, folate, vitamin B12, vitamin D, zinc, and magnesium are common in untreated celiac disease patients 4
• Iron deficiency anemia is the most common extra-intestinal sign of celiac disease and usually resolves with adherence to a gluten-free diet 4, 5
• Deficiencies of folate and vitamin B12 may persist in some patients on a gluten-free diet 4
• Supplementation of vitamin D and calcium is recommended in cases where bone mineral density does not normalize with a gluten-free diet 4
• Magnesium deficiency may persist despite a gluten-free diet, and a magnesium-enriched diet is recommended 4
• Nutritional imbalances, including low complex carbohydrate and fiber intakes, and high fat and sugar intakes, are common in adult celiac patients following a gluten-free diet 6