Symptoms of coeliac disease can range from mild to severe, and often come and go. Mild cases may not cause any noticeable symptoms, and the condition is often only detected during testing for another condition.
Treatment is recommended even when symptoms are mild or non-existent, because complications can still occur.
Common symptoms
Diarrhoea is the most common symptom of coeliac disease. It’s caused by the body not being able to fully absorb nutrients (malabsorption). Malabsorption can also lead to stools containing abnormally high levels of fat (steatorrhoea). This can make them foul smelling, greasy and frothy. They may also be difficult to flush down the toilet.
Digestive signs and symptoms for adults include:
- Diarrhea
- Fatigue (extreme tiredness), which may be a sign of iron deficiency anaemia or vitamin B12 folate deficiency anaemia
- Weight loss
- Indigestion
- Bloating and gas (flatulence passing wind)
- Abdominal pain
- Nausea and vomiting (usually only affects children)
- Constipation
However, more than half the adults with celiac disease have signs and symptoms that are unrelated to the digestive system. Such symptoms include:
- Anemia, usually from iron deficiency
- Loss of bone density (osteoporosis) or softening of bone (osteomalacia)
- Itchy, blistery skin rash (dermatitis herpetiformis)
- Mouth ulcers
- Headaches and fatigue
- Nervous system injury, including numbness and tingling in the feet and hands, possible problems with balance, and cognitive impairment
- Joint pain
- Reduced functioning of the spleen (hyposplenism)
Signs and symptoms for children include:
Children with celiac disease are more likely than adults to have digestive problems, including:
- Nausea and vomiting
- Chronic diarrhea
- Swollen belly
- Constipation
- Gas
- Pale, foul-smelling stools
The inability to absorb nutrients might result in:
- Failure to thrive for infants
- Damage to tooth enamel
- Weight loss
- Anemia
- Irritability
- Short stature
- Delayed puberty
- Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), learning disabilities, headaches, lack of muscle coordination and seizures
Some other symptoms
- difficulty getting pregnant
- tingling and numbness in your hands and feet (peripheral neuropathy)
- disorders that affect co-ordination, balance and speech (ataxia)
- swelling of the hands, feet, arms and legs caused by a build-up of fluid (oedema)
It’s important to work with a healthcare provider to determine the underlying cause of coeliac disease and develop an appropriate treatment plan, which is a strict gluten-free diet, and regular monitoring of the symptoms and complications.