Symptoms of celiac disease
The symptoms vary
The symptoms of celiac disease (often called gluten intolerance and sometimes incorrectly referred to as a gluten allergy) are many and vary from person to person—from classic stomach and intestinal problems to completely different complaints, or no noticeable symptoms at all. Contrary to what was previously believed, it is now clear that celiac disease occurs and can develop at any age. Today, celiac disease is diagnosed in children, adults, and older people. But because the symptoms can vary so much, the disease can be difficult to identify. The symptoms disappear after some time on a gluten-free diet. How long this takes depends, among other things, on age and how long the celiac disease has gone untreated. Children often notice an improvement within a few weeks.
Symptoms of untreated celiac disease
Celiac disease is a complex condition that can affect the entire body. Untreated celiac disease is characterized by inflammation in the small intestine, damage to the intestinal villi, and certain biomarkers (antibodies) in the blood. The surface area of the small intestine—where nutrients from food are absorbed—gradually becomes smaller. This leads to nutrient deficiencies, which can cause a range of symptoms. Far from everyone develops classic gastrointestinal problems such as diarrhea, stomach cramps, gas, constipation, weight gain, or weight loss. Nutrient deficiencies can instead lead to symptoms such as poor growth (in children), delayed puberty, fatigue, depression, osteoporosis, joint pain, and enamel defects on the teeth. Some people, however, feel they have no symptoms at all.
Secondary lactose intolerance
A symptom of untreated celiac disease can also be that you feel sensitive to dairy products. Damage in the small intestine reduces the activity of the enzyme lactase, which makes it difficult to break down lactose (milk sugar). This is called secondary lactose intolerance. It is not “true” lactose intolerance, but rather a result of intestinal damage from untreated celiac disease. When a gluten-free diet is introduced, the lactose intolerance usually disappears. Unfortunately, celiac disease is easy to miss in cases of secondary lactose intolerance, because many symptoms improve on a lactose-free diet.
Asymptomatic celiac disease (silent celiac disease)
There is a group of people who feel completely fine and do not experience any symptoms at all—despite having untreated celiac disease. This used to be called “silent celiac disease” but is now referred to as asymptomatic celiac disease. It is celiac disease without any perceived symptoms when gluten is consumed. People with asymptomatic celiac disease are, of course, difficult to identify, and many probably do not know they have celiac disease. But if they are found (through screening or during medical visits for other reasons) and start a gluten-free diet, they often find after a period on the diet that they actually feel better than before.
DIFFERENT SYMPTOMS
Symptoms in children and adolescents with celiac disease
In children, the symptom pattern varies with age. Celiac disease often shows up as gastrointestinal symptoms, but more subtle signs are also common, such as fatigue, enamel defects on the teeth, and delayed puberty. Below are some examples of common symptoms of untreated celiac disease in children and adolescents:
Young children (0–2 years):
Poor appetite, stomach pain, vomiting, nausea, diarrhea, constipation, bloated abdomen/thin limbs, fatigue, irritability, weight loss or poor growth, and delayed development.
Older children and adolescents (3–18 years):
Poor appetite, upset stomach, stomach pain, nausea, diarrhea, constipation, fatigue, mood swings, depression, weight loss or poor growth and delayed development, delayed puberty, missed periods, anemia, and enamel defects on the teeth.
Symptoms in adults with celiac disease
In older children and adults, the signs are often both long-lasting and non-specific. In adults, in addition to gastrointestinal problems, this can also involve issues such as low mood. Common symptoms of untreated celiac disease in adults include:
Gastrointestinal problems, menstrual irregularities, anemia, weight loss, enamel defects on the teeth, osteoporosis and recurrent fractures, fatigue, mood swings, and depression.
Symptoms affecting the skin
One variant of celiac disease is dermatitis herpetiformis (DH, or “skin celiac disease”). Read more about dermatitis herpetiformis (skin celiac disease) here.