Celiac Disease - Symptoms, Risks and Diagnosis
Celiac disease is a chronic digestive disorder resulting from an immune reaction to gliadin, a gluten protein found in wheat, barley, rye, and sometimes oats. It involves inflammation and destruction of the inner lining of the small intestine and can lead to the malabsorption of minerals and nutrients.
If you have celiac disease, eating gluten triggers an immune response in your small intestine. Over time, this reaction damages your small intestine's lining and prevents it from absorbing some nutrients (malabsorption). The intestinal damage often causes diarrhea, fatigue, weight loss, bloating and anemia, and can lead to serious complications.
In children, malabsorption can affect growth and development, besides causing the symptoms seen in adults.
Celiac disease symptoms in children
Children with celiac disease can feel tired and irritable. They may also be smaller than normal and have delayed puberty. Other common symptoms include:
pale, fatty, foul-smelling stools
Celiac disease symptoms in adults
Adults with celiac disease may experience digestive symptoms. In most cases, however, symptoms also affect other areas of the body. These symptoms may include:
weak, brittle bones
numbness and tingling in the hands and feet
tooth discoloration or loss of enamel
pale sores inside the mouth
irregular menstrual periods
infertility and miscarriage
Dermatitis herpetiformis (DH) is another common symptom of celiac disease. DH is an intensely itchy skin rash made up of bumps and blisters. It may develop on the elbows, buttocks, and knees. DH affects approximately 15 to 25 percent of people with celiac disease. Those who do experience DH usually don’t have digestive symptoms.
Celiac disease tends to be more common in people who have:
A family member with celiac disease or dermatitis herpetiformis
Type 1 diabetes
Down syndrome or Turner syndrome
Autoimmune thyroid disease
Microscopic colitis (lymphocytic or collagenous colitis)
Serology testing looks for antibodies in your blood. Elevated levels of certain antibody proteins indicate an immune reaction to gluten.
Genetic testing for human leukocyte antigens (HLA-DQ2 and HLA-DQ8) can be used to rule out celiac disease
Endoscopy. This test uses a long tube with a tiny camera that's put into your mouth and passed down your throat (upper endoscopy). The camera enables your doctor to view your small intestine and take a small tissue sample (biopsy) to analyze for damage to the villi.
Untreated, celiac disease can cause:
Malnutrition. This occurs if your small intestine can't absorb enough nutrients. Malnutrition can lead to anemia and weight loss. In children, malnutrition can cause slow growth and short stature.
Bone weakening. Malabsorption of calcium and vitamin D can lead to a softening of the bone (osteomalacia or rickets) in children and a loss of bone density (osteopenia or osteoporosis) in adults.
Infertility and miscarriage. Malabsorption of calcium and vitamin D can contribute to reproductive issues.
Lactose intolerance. Damage to your small intestine might cause you abdominal pain and diarrhea after eating or drinking dairy products that contain lactose. Once your intestine has healed, you might be able to tolerate dairy products again.
Cancer. People with celiac disease who don't maintain a gluten-free diet have a greater risk of developing several forms of cancer, including intestinal lymphoma and small bowel cancer.
Nervous system problems. Some people with celiac disease can develop problems such as seizures or a disease of the nerves to the hands and feet (peripheral neuropathy).