While there are a number of symptoms that people with celiac disease experience, at the current time, most people with celiac disease do not have symptoms or have what are considered “atypical symptoms.” Because the new blood tests in wide use are very accurate, it is easy to screen people for celiac disease. Doctors are finding positive blood tests in people without “classic” symptoms, meaning symptoms that were thought to occur in all people with celiac disease.
It is now said that most people (over half) with celiac disease have no symptoms. Whereas it used to be considered a rare disorder, it is thought to occur in approximately 1% of the population in the United States.
Some of these people really do not have symptoms and are screened and diagnosed because of a positive family history. Others may be found because they have a disease that can be associated with celiac disease, for example, osteoporosis (thin bones) at a young age, and their doctors are appropriately looking to see if they have celiac disease as well. These patients do not get the diagnosis just from blood tests. People with positive blood tests will go on to have intestinal biopsies in order to confirm celiac disease.
Within this group of patients with no clear intestinal symptoms, some diagnosed with celiac disease are put on a gluten-free diet then realize that they did have symptoms. They may have had mild diarrhea that then goes away, or fatigue that gets better.
However, there really are “classic” symptoms of celiac disease which cause a great deal of suffering in affected individuals.
Celiac disease is diagnosed in very young children who have the classic symptoms of diarrhea, abdominal distension (bloating) and what is called “failure to thrive.” This means the children are malnourished and not gaining weight and developing normally. Children can also have abdominal pain and constipation. Their stools will not look normal. The severity of intestinal symptoms parallels the amount of actual damage to the small intestine.
Older children are more likely to be evaluated because of other illnesses. Children with diabetes, thyroid disease and other known associated diseases are being screened for celiac disease at an early age. Many more children are now found to have celiac disease. In one study, more than half of the children evaluated for celiac disease had no gastrointestinal symptoms. If celiac disease can be diagnosed early, before the onset of severe intestinal symptoms, and a gluten-free diet followed, this will lead to less actual damage to the intestine and better health.
Classical symptoms in adults also include diarrhea, bloating, and pain. Less than half of the adults now diagnosed with CD have the classic symptoms. If you have prolonged diarrhea, abdominal pain, and bloating, you should be seeking medical attention. Your doctor should be evaluating you for all causes of these symptoms, including celiac disease.
However, most adults diagnosed with CD have no gastrointestinal symptoms and they are screened because they are in a high risk group for CD. They may have atypical symptoms or other diseases known to be associated with CD. These include:
- Anemia – especially unexplained anemia due to low iron
- Fatigue (unexplained)
- Osteoporosis (thin bones) at a young age
- Short stature
- Autoimmune disorders (especially thyroid disease) – Bone, joint pain or Arthritis
- Depression, anxiety, other psychiatric symptoms
- Tingling in hands or feet (neuropathy)
- Type 1 diabetes
- Missed menstrual periods/infertility and/or recurrent miscarriages
- Sores inside the mouth
- Dermatitis herpetiformis
- Liver disease
If you have no specific abdominal symptoms but you know you are at high risk for celiac disease because of your family history, or because you have one of the other diseases and/or symptoms that are associated with CD, you should ask your doctor to do the antibody tests.
If they are positive, you will need to get a definite diagnosis by intestinal biopsy. While that may not sound appealing, if you can get a diagnosis before your intestines are severely damaged, you will have less symptoms and other medical problems as a result of celiac disease.