Celiac Disease – Symptoms and Causes
Overview
Celiac disease occurs when the body’s immune system reacts to gluten, a protein in wheat, barley, and rye. This reaction damages the small intestine lining, preventing proper nutrient absorption—a condition known as malabsorption.
Common symptoms include:
- Diarrhea
- Fatigue
- Weight loss
- Bloating
- Anemia
In children, this condition can interfere with normal growth and development, alongside causing digestive problems. Without proper management, celiac disease may lead to serious health complications.
There is no permanent cure for celiac disease, but most patients can manage symptoms by adhering to a strict gluten-free diet. This dietary approach helps the intestines heal and prevents further damage.
Signs and Symptoms
People with celiac disease may have many different symptoms. Adults and children often show different signs of the condition.
Common Symptoms in Adults
- Diarrhea
- Feeling tired
- Weight loss
- Gas and bloating
- Stomach pain
- Feeling sick or throwing up
- Constipation
More than half of adults with celiac disease have symptoms not related to digestion, such as:
- Low iron levels leading to anemia
- Bone loss or softening
- Itchy skin rash
- Sores in the mouth
- Headaches and tiredness
- Tingling in hands and feet
- Joint pain
- Problems with the spleen
- High liver enzymes
How Children Show Signs
Children with celiac disease are more likely to experience digestive symptoms, including:
- Feeling sick and throwing up
- Ongoing diarrhea
- Swollen belly
- Constipation
- Gas
- Foul-smelling, pale bowel movements
Because celiac disease affects nutrient absorption, children may also experience:
- Poor growth in babies
- Damaged tooth enamel
- Weight loss
- Anemia
- Being irritable
- Being shorter than expected
- Delayed puberty
- Brain-related symptoms like ADHD, learning problems, headaches, poor muscle coordination, and sometimes seizures
Skin Rash (Dermatitis Herpetiformis)
Gluten intolerance can cause a blistering skin disease. This itchy rash typically appears on elbows, knees, torso, scalp, or buttocks.
The skin condition causes similar changes in the small intestine as celiac disease, but some individuals may not experience digestive symptoms.
Health providers treat this skin condition with a gluten-free diet, medication, or both to control the rash.
When To Consult Your Doctor
See your doctor if you have:
- Diarrhea lasting more than two weeks
- Persistent digestive discomfort
For children, contact a doctor if your child:
- Looks pale
- Seems irritable
- Isn’t growing as expected
- Has a potbelly
- Passes foul-smelling, bulky stools
Important: Don’t start a gluten-free diet before being tested for celiac disease, as reducing gluten can change your test results.
Causes
Celiac disease occurs due to a mix of genetic and environmental factors. When people with genetic risk eat gluten-containing foods, their immune system can react abnormally. This reaction isn’t fully understood yet by scientists.
Several triggers might activate celiac disease, including:
- Surgery
- Pregnancy or childbirth
- Viral infections
- Severe emotional stress
The disease involves an immune system overreaction to gluten proteins found in wheat, barley, and rye. This immune response damages the villi—small, finger-like projections lining the small intestine. These villi play a crucial role in nutrient absorption.
When villi become damaged, they can’t properly absorb:
- Vitamins
- Minerals
- Other essential nutrients
This explains why people with celiac disease may experience nutritional deficiencies despite eating adequate amounts of food.
Risk Factors
People with a family history of celiac disease have a higher chance of developing it. The condition is also more common in those with certain health issues:
- Type 1 diabetes
- Down syndrome, Williams syndrome, or Turner syndrome
- Autoimmune thyroid disease
- Microscopic colitis
- Addison’s disease
- Dermatitis herpetiformis
These conditions often share connections with the immune system problems that cause celiac disease.
Health Complications
When Celiac Disease Doesn’t Respond to Treatment
People with celiac disease who still experience symptoms while following a gluten-free diet have non-responsive celiac disease. The most common cause is unintentional gluten exposure. Working with a nutrition expert can help identify hidden sources of gluten in your diet.
Several other conditions may cause ongoing symptoms:
- Bacterial overgrowth in the small intestine
- Microscopic colitis, an inflammatory condition
- Pancreatic insufficiency, where digestive enzymes aren’t properly produced
- Irritable bowel syndrome
- Sugar intolerances affecting lactose, sucrose, or fructose
When the Intestine Doesn’t Heal
In rare cases, intestinal damage continues despite strict gluten avoidance. This is called refractory celiac disease.
If symptoms persist after 6–12 months on a strict gluten-free diet, additional testing may be needed.
Untreated celiac disease can lead to serious health problems:
| Complication | Description |
|---|---|
| Malnutrition | Poor nutrient absorption causes anemia, weight loss, and growth problems in children |
| Bone problems | Calcium and vitamin D deficiency leading to osteomalacia in children or osteoporosis in adults |
| Reproductive issues | Higher rates of infertility and miscarriage |
| Lactose intolerance | Temporary inability to digest dairy products |
| Cancer risk | Increased chance of intestinal lymphoma and small bowel cancer |
| Neurological problems | Conditions like seizures or peripheral neuropathy affecting nerves in the hands and feet |
Most of these complications can be prevented with strict adherence to a gluten-free diet. Regular follow-up care is important, especially for those who continue to have symptoms despite treatment.
