Although the best-known (but not necessarily most common) symptoms of celiac disease include smelly diarrhea, abdominal pain, weight loss and fatigue, celiac can affect just about every system in your body, including your skin, your hormones and your bones and joints.
People with celiac disease might suffer from constipation instead of diarrhea, experience weight gain instead of weight loss and endure heartburn instead of stomach pain. They might also have absolutely no symptoms at all, or they might appear at their doctor's office with one seemingly unrelated symptom, such as unexplained anemia.
In fact, it's doubtful that there's a truly "typical" case of celiac disease; the condition affects too many body systems in too many different ways.
It also affects women, men and children in different ways:
Because every person exhibits celiac disease symptoms differently, it's also a very difficult condition for doctors to diagnose correctly. In fact, although celiac disease awareness and diagnosis rates appear to be improving, in years past the typical American celiac patient could go for up to ten years without a diagnosis, in some cases despite debilitating symptoms.
Of course, keep in mind that all of these potential celiac disease symptoms can be caused by other medical conditions, possibly including non-celiac gluten sensitivity, which is thought to be a separate condition. That's another major reason this diagnosis is so difficult to make. The only way you can tell for certain that you have celiac disease is to have an intestinal biopsy that shows villous atrophy.
Once you're diagnosed with celiac, it's for life. To avert long-term complications, which can include certain cancers, you must follow a strict gluten-free diet. However, the good news is that following a strict gluten-free diet generally resolves most or all of your symptoms.
In fact, while you'd expect the diet to resolve your gastrointestinal symptoms -- and in most cases it will -- it's actually very common for you to experience marked improvement in other, minor ailments you never would have imagined were related to celiac disease.
Here's a breakdown of celiac disease symptoms and related conditions, categorized by the body system they affect.
Gastrointestinal Symptoms of Celiac Disease
Not everyone who's diagnosed with celiac disease experiences gastrointestinal symptoms, but many do. For example, one study found such symptoms in about three-quarters of people with new diagnoses.
Chronic diarrhea is one hallmark symptom of celiac disease, and appears to affect half or more of those newly diagnosed. Frequently, the diarrhea is watery, smelly and voluminous, and floats rather than sinking.
However, a significant minority of people with celiac disease tend to have constipation rather than diarrhea, and some alternate between the two.
In addition, other gastrointestinal symptoms can appear. For example, flatulence and excessive gas is common, as is abdominal bloating (many people describe themselves as looking "six months pregnant"). It's also common to have abdominal pain, which can be severe at times.
Additional gastrointestinal symptoms of celiac disease include heartburn and reflux (potentially with a diagnosis of gastroesophageal reflux disease), nausea and vomiting, and lactose intolerance. Undiagnosed celiacs sometimes develop pancreatitis or gallbladder disease.
In addition, not everyone loses weight as an undiagnosed celiac. In fact, many people find they gain weight prior to diagnosis. Some people report being absolutely unable to shed excess pounds, no matter how much they diet and exercise. In my experience of corresponding with readers and others, weight gain or being overweight frequently is coupled with constipation as the primary gastrointestinal symptom.
More on gastrointestinal celiac disease symptoms:
- Celiac Disease and Constipation
- Celiac Disease or Irritable Bowel Syndrome?
- GERD Symptoms and Celiac Disease
- Celiac Disease and Reflux
- Weight and Celiac Disease
- Untreated Celiac Disease and Malnutrition
- Lactose Intolerance and Celiac
Neurological Celiac Disease Symptoms
Many people with undiagnosed celiac experience extreme fatigue that prevents them from performing everyday tasks and impacts their quality of life. Generally, fatigue seems to creep up on you, making it easy to blame it on getting older.
At the same time, insomnia and other sleep disorders are very common in people with celiac. In fact, one study compared celiacs at diagnosis and on a gluten-free diet with non-celiac controls, and found both untreated and treated celiacs fared worse on measures of sleep quality.
It's the worst of both worlds: you're exhausted during the day, but can't fall asleep or stay asleep at night.
In addition, many celiacs get "brain fog" due to gluten. When you have brain fog, you have trouble thinking clearly -- it literally feels as if your brain is operating in a fog. You might have trouble coming up with the right words to carry on an intelligent conversation, or you might misplace your car keys or fumble other common household tasks.
Some newly diagnosed celiacs already have diagnoses of migraine headaches; in many cases (but not all), these headaches will lessen in severity and frequency or even clear up completely once you adopt a gluten-free diet.
Psychological symptoms such as depression, anxiety and irritability occur frequently in people with undiagnosed celiac disease. In fact, long-diagnosed celiacs often can tell they've been exposed to gluten through their irritability -- that symptom can appear within hours of exposure and linger for several days.
Peripheral neuropathy, in which you experience numbness, a sensation of pins and needles and potentially weakness in your extremities, is one of the most frequently reported neurological symptoms of celiac disease. In addition, some people are diagnosed with gluten ataxia, a condition characterized by the loss of balance and coordination due to gluten consumption.
Restless leg syndrome even has been reported as a common symptom of celiac disease. In one study, 31% of celiacs had restless leg syndrome, compared with just 4% of control subjects.
More on neurological symptoms in celiac disease:
- Gluten-Related Neurological Symptoms
- Celiac Disease and Migraine
- Gluten and Sleep
- Gluten and Brain Fog
- Gluten and ADHD
- Gluten and Depression
- Gluten Ataxia
- Celiac Disease in Elderly Patients
- Complications of Untreated Celiac Disease