What are the symptoms of celiac disease?

Diana Meeks
Diana Meeks on behalf of Sigma Nursing
Family Practitioner

Symptoms of celiac disease vary based on age, and some people experience few if any symptoms. In children, celiac disease may present with symptoms that relate to digestive dysfunction. A large abdomen, abnormal stools, vomiting, trouble gaining weight, or noticeable weight loss may be signs that a child has celiac disease.

Adults who exhibit symptoms may notice mood changes, joint and bone pain, tiredness, limbs that tingle or fall asleep, weight loss, stool change, upset stomach, and sores in their mouths. Women may experience changes in their menstrual cycle and inability to conceive or carry a baby to term.

Chronic diarrhea is one of the common symptoms associated with celiac disease. Often dermatological manifestation of celiac disease is seen as an itchy skin rash-dermatitis herpetiformis. As a result of the malabsorption of nutrients, patients with celiac disease can present with weight loss, pale/foul smelling stools, muscle cramps, recurrent abdominal gas/ pain, iron deficiency anemia, bone and joint pain, fatigue, tingling or numbness in the legs, painful mouth sores. Other presenting features Include abnormal liver tests, tooth discoloration or loss of enamel, behavioral changes, and seizures.

Some people with celiac disease will have classic symptoms like diarrhea, abdominal pain and foul smelling, floating stools. They may have abnormal lab test results because they are not absorbing all the vitamins and nutrients from their food. Others may have a mild form of the disease and have no symptoms or complain only of fatigue. A wide range of other symptoms including arthritis, low iron and depression have also been associated with celiac disease.

Some people with celiac disease have no symptoms, which makes this disease difficult to diagnose. Other symptoms are mistaken for other ailments, such as irritable bowel syndrome, Crohn's disease and cystic fibrosis. Some signs to look for include excessive gas, abdominal pains, chronic diarrhea, foul-smelling bowel movements and weight loss in spite of eating a hearty diet. Some people with celiac disease also experience fatigue, joint pain, muscle cramps, depression and irritability. In addition, there is a rash associated with celiac disease. Called dermatitis herpetiformis, it causes itching and blistering on the knees, elbows and rear end.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

The symptoms can be hard to pinpoint, but the most common general complaints are abdominal pain, bloating and intermittent diarrhea. Sometimes people with Celiac disease have no abdominal symptoms at all, and instead present with complains that include irritability, joint pain, muscle cramps, mouth sores, tingling in the feet, or even with a rash called Dermatitis herpetiformis—an itchy, blistering skin disease caused by gluten intolerance.

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Celiac disease is an autoimmune disorder that leads to damage of the small intestine and keeps the body from fully absorbing nutrients. Signs and symptoms of malabsorption vary greatly among individuals. Since many cases of the disorder go undiagnosed, it's important to be aware of the symptoms, which include:

  • Gas
  • Diarrhea
  • Stomach pain
  • Fatigue
  • Joint pain
  • Indigestion
Dr. Robynne K. Chutkan, MD

In its classic form, celiac disease causes weight loss and diarrhea, but patients often present with a variety of symptoms, including fatigue, dry skin, rashes, smooth tongue, abdominal discomfort, joint pain, headache, anemia, depression, anxiety, tingling in hands or feet, menstrual abnormalities, smelly stools, constipation, weight gain and the commonest complaint of all: bloating.

The fact that the symptoms are so varied and non-specific makes this a hard condition to self-diagnose. Many, many people are bloated and tired, and most of them don't have celiac disease.

Nancee Jaffe, RD
Nutrition & Dietetics Specialist

The symptoms of celiac disease are varied. The small intestine is in charge of absorbing all of our nutrition and using it to help the body in all the different ways in which it has to perform. This means that the whole body can be affected if a person who has celiac disease is not following a gluten-free diet. There is classic celiac disease, with all the gastrointestinal symptoms such as gas and bloating, diarrhea or constipation, weight loss and malnutrition. However, many people have atypical symptoms of celiac disease. Those atypical symptoms can include iron-deficiency anemia, infertility, tooth decay, fatigue, skin issues, joint pain, migraines, bone loss and hair loss.

Dr. Donald J. Brust, MD

While each patient has his or her own unique spectrum of presenting symptoms of celiac disease, some of the more common ones include bloating, excessive gas, abdominal cramping or discomfort, anemia and weight loss. Other symptoms may also occur as a result of nutrient and vitamin deficiencies. In many cases, symptoms are mild and even absent in the early stages of the disease.

Dr. Michael T. Murray, ND
Naturopathic Medicine Specialist

Symptoms of celiac disease most commonly appear during the first three years of life, after cereals are introduced into the diet. A second peak incidence occurs during the third decade. Symptoms generally involve loose stools or diarrhea, often with fat drops in the stool showing malabsorption. Other signs of malabsorption include inability to gain weight or weight loss, as well as failure to thrive. However, often, especially in adults, the symptoms of celiac disease can be insidious and nonspecific. Celiac disease is being diagnosed more commonly than was once the case, due to increased detection of those with low-grade celiac disease.

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Dr. Patricia L. Raymond, MD

Not all with celiac disease have bowel symptoms such as gas, bloating or diarrhea; many have constipation or are asymptomatic. But what I find absorbing (pun intended) about celiac disease are the other syndromes that may be associated with it, and that might improve on a gluten free diet. This is not an exhaustive list:

  • Anemia: 3% of low iron folks have celiac, all should be tested.
  • Autoimmune diseases: thyroid, type 1 diabetes coexist more frequently with celiac; diabetes seems to improve when GFD is started in patients with both celiac and diabetes.
  • Cancers: Small intestinal cancers such as lymphoma, adenocarcinoma, as well as esophagus cancer, non-Hodgkins lymphoma, melanoma, colon cancer, pancreas cancer are increased in folks with celiac disease.
  • Cardiology: Cardiomyopathy
  • Dermatology: Dermatitis, herpetiformis, atopic dermatitis (3.8% of people with celiac have atopic dermatitis).
  • Dental: Dental enamel defects occur in 24.5% of celiac vs 6.2% of control patients.
  • Downs syndrome: 8% have celiac, but it is not felt to be causal relationship.
  • Neurology: seizures, brain calcifications, ADHD, chorea (a movement disorder), multifocal axonal neuropathy, migraines, cerebellar ataxia.
  • Osteoporosis and bone fractures: Celiacs have 2.45 times the risk of peripheral fractures, 3.17 times risk of axial (spine) fractures; 19% spontaneous fractures compared with 8% without celiac disease.
  • Pediatrics: Failure to thrive, delayed puberty, ADHD.
  • Reproduction problems in both men and women: Infertility, decreased sperm count.
Joan Salge Blake, MS, RD
Nutrition & Dietetics Specialist

Individuals with celiac disease who consume gluten can trigger inflammatory responses in their bodies that damage the lining of the small intestine and interfere with the digestion and absorption of the nutrients in food. This leads to numerous vitamin, minerals, and other nutrient deficiencies, as well as corresponding short-term health problems, such as depression, anemia, abdominal pain, irritability, nausea, weight loss, diarrhea, and fatigue—to name a few.

Celiac disease can be difficult to diagnose because the symptoms affect people differently. There are about 300 known symptoms which may occur in the digestive system or other parts of the body. Some people with celiac disease have no symptoms at all. However, all people with celiac disease are still at risk for long-term complications, whether or not they display any symptoms. 

Adults are less likely to have digestive symptoms, with only one-third experiencing diarrhea. Adults are more likely to have:

  • unexplained iron-deficiency anemia
  • fatigue
  • bone or joint pain
  • arthritis
  • bone loss or osteoporosis
  • depression or anxiety
  • tingling numbness in the hands and feet
  • seizures or migraines
  • missed menstrual periods
  • infertility or recurrent miscarriage
  • canker sores inside the mouth
  • an itchy skin rash called dermatitis herpetiformis

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.