9 Symptoms of Celiac Disease

1. Diarrhea

Loose, watery stool is one of the first symptoms that many people experience before being diagnosed with celiac disease.

According to one study, around 43% of people with celiac disease have diarrhea. This percentage is significantly lower than it was before the introduction of blood tests, which are now widely used to diagnose celiac disease (2).

Fortunately, following a gluten-free diet usually resolves many symptoms of celiac disease, including diarrhea. In fact, in one study in people with celiac disease, those who followed a gluten-free diet reported significantly less diarrhea than those who didn’t (3).

However, keep in mind that there are many other possible causes of diarrhea, such as infection, other food intolerances, or other intestinal issues (4).

Summary

Diarrhea is one of the most common symptoms of celiac disease. Following a gluten-free diet can effectively reduce and resolve diarrhea.

2. Bloating

Bloating is another common symptom that people with celiac disease experience.

Celiac disease can cause inflammation in your digestive tract, which may result in bloating and other digestive issues (1).

In a small study in 85 people newly diagnosed with celiac disease, around 9% experienced bloating, alongside other digestive symptoms (5).

Another study in 200 people with this condition showed that following a gluten-free diet significantly reduced symptoms like bloating and improved quality of life (6).

In some cases, gluten may cause digestive concerns like bloating even for people who don’t have celiac disease. For instance, one study found that gluten worsened symptoms like stomach pain, bloating, and fatigue in people with irritable bowel syndrome (IBS) (7).

Aside from celiac disease, other common causes of bloating include (8):

• constipation
• bowel obstruction
• chronic gas
• digestive disorders

Summary

People with celiac disease often experience bloating. Gluten may also cause bloating for individuals without this condition.

3. Gas

Excess gas is a common digestive issue experienced by people with untreated celiac disease.

According to one study in 130 children with celiac disease, approximately 47% experienced increased flatulence (9).

Similarly, an older study in 193 adults with celiac disease found that around 7% experienced excess gas (10).

However, keep in mind that there are many causes of gas. One study in 150 people complaining of increased gas found that only 2 individuals tested positive for celiac disease (11).

Other, more common causes of gas include (12):

• constipation
• indigestion
• swallowing air
• conditions like lactose intolerance and IBS

Summary

Studies show that gas is one of the most common symptoms of untreated celiac disease, though gas can be caused by many other conditions as well.

4. Fatigue

Decreased energy levels and fatigue are common in people with celiac disease.

One large review found that people with celiac disease had high levels of fatigue, which generally improved after following a gluten-free diet (13).

Another study found that those with celiac disease were more likely to have issues associated with sleep, which may also contribute to fatigue (14).

Additionally, untreated celiac disease can cause damage to your small intestine, resulting in vitamin and mineral deficiencies that may also lead to decreased energy levels (15, 16).

Other potential causes of fatigue include infection, thyroid problems, depression, and anemia (17).

Summary

Fatigue is a common concern for people with celiac disease. Studies show that those with celiac disease are more likely to have sleep disorders and nutritional deficiencies, which may be contributing factors.

5. Weight loss

A sharp drop in weight and difficulty keeping weight on are often early signs of celiac disease. This is because your body’s ability to absorb nutrients is impaired, which may lead to malnutrition and weight loss.

One study found that nearly 29% and 26% of children with celiac disease had a low body weight and low body mass index (BMI), respectively (18).

In an older study in older adults with celiac disease, weight loss was one of the most common symptoms. Following treatment, not only were symptoms completely resolved, but participants gained an average of 17 pounds (7.75 kg) (19).

Similarly, another study in 42 children with this condition found that following a gluten-free diet significantly increased body weight and BMI after 1 year (20).

Unexplained weight loss may also be caused by conditions like diabetes, cancer, depression, or thyroid problems (21).

Summary

Many people with celiac disease experience unexplained weight loss. However, following a gluten-free diet typically helps people increase their body weight.

6. Iron deficiency anemia

Celiac disease may impair nutrient absorption and lead to iron deficiency anemia, a condition caused by a lack of healthy red blood cells (22).

Symptoms of iron deficiency anemia include:

• fatigue
• weakness
• chest pain
• headaches
• dizziness

According to one review, iron deficiency anemia is present in approximately 40% of people with celiac disease (23).

Another study in 455 children with celiac disease found that 18% were anemic. In 92% of participants, anemia resolved after they followed a gluten-free diet for an average of 1 year (24).

Similarly, an older study in 727 celiac patients reported that 23% were anemic. Those with anemia were twice as likely to have severe damage to the small intestine, as well as a low bone mass caused by celiac disease (25).

However, there are many other potential causes of iron deficiency anemia, including (26):

• a poor diet
• the long-term use of pain relievers like aspirin
• blood loss through heavy menstrual bleeding or peptic ulcers

Summary

Celiac disease impairs nutrient absorption, which may lead to iron deficiency anemia. Nevertheless, there are several other potential causes of iron deficiency anemia.

7. Constipation

While celiac disease may cause diarrhea in some people, it may cause constipation in others.

Celiac disease damages the intestinal villi. These are tiny fingerlike projections in the small intestine, and they are responsible for absorbing nutrients.

As food travels through your digestive tract, the intestinal villi are unable to fully absorb nutrients and may often absorb extra moisture from the stool instead. This leads to hardened stool that’s difficult to pass, resulting in constipation (27).

However, even on a strict gluten-free diet, people with celiac disease may find it challenging to avoid constipation.

This is because a gluten-free diet cuts out many high fiber foods like grains, which may result in decreased fiber intake and reduced stool frequency (28).

Physical inactivity, dehydration, and a poor diet can cause constipation, too (29).

Summary

Celiac disease may cause your small intestine to absorb moisture from the stool, resulting in constipation. Additionally, a gluten-free diet may decrease fiber intake and cause constipation.

8. Depression

Celiac disease results in psychological symptoms like depression alongside physical symptoms.

An older analysis of 29 studies found that depression was more common and severe in adults with celiac disease than in the general population (30).

Another review of 37 studies linked celiac disease to an increased risk of depression, anxiety, and eating disorders (31).

Furthermore, one review noted that anxiety, depression, and fatigue were commonly reported among those with untreated celiac disease, which may negatively affect quality of life and dietary adherence (32).

However, there are many other potential causes of depression, including (33):

• shifts in hormone levels
• stress
• grief
• genetics

Summary

Celiac disease is associated with an increased risk of depression, along with other conditions like anxiety and eating disorders. These conditions may make it more difficult to adhere to a gluten-free diet.

9. Itchy rash

Celiac disease may cause dermatitis herpetiformis. This is a type of itchy, blistering skin rash that occurs on your elbows, knees, or buttocks.

Approximately 17% of people with celiac disease experience this rash, and it is one of the telltale symptoms that leads to a diagnosis. It may also develop after diagnosis as a sign of poor adherence to treatment (34).

People who develop this skin rash rarely experience the other digestive symptoms that commonly accompany celiac disease (35).

Other potential causes of an itchy skin rash besides celiac disease include (36):

• eczema
• psoriasis
• dermatitis
• hives

Summary

Celiac disease can cause a type of itchy skin rash. Most people who develop this rash don’t experience any digestive symptoms.

Celiac symptoms in children

The onset and severity of symptoms vary widely in children with celiac disease (37).

Some children experience symptoms shortly after consuming gluten, which typically resolve very quickly. Others may have symptoms that last several days or weeks, while others have no symptoms at all (37).

Symptoms also differ depending on age. For infants and toddlers, some of the most common symptoms include (37):

• bloating
• vomiting
• diarrhea
• malnutrition
• impaired growth
• irritability

School-age children often report symptoms like (37):

• constipation
• diarrhea
• unintentional weight loss or difficulty gaining weight
• stomach pain
• abdominal distension

Finally, older children and teenagers commonly experience symptoms including (37):

• delayed puberty
• stunted growth
• unintentional weight loss
• fatigue
• bone or joint pain
• frequent headaches or migraines
• skin rashes
• mouth sores
• depression
• anxiety

If you suspect that your child may have celiac disease, it’s best to talk with their pediatrician about getting tested to determine whether treatment is necessary.

Summary

Symptoms of celiac disease in children can vary in onset and severity, as well as based on age.

What other health concerns can accompany celiac disease?

If left untreated, celiac disease may be associated with several other health concerns, such as (15, 38, 39, 40, 41):

• nutritional deficiencies
• infertility
• osteoporosis, or bone loss
• gluten neuropathy, or numbness, tingling, and nerve pain
• bone, muscle, or joint pain

Additionally, celiac disease is an autoimmune disorder. This is a condition that occurs when your immune system attacks the healthy cells in your body (42).

Research shows that people with one autoimmune disorder have a 25% higher risk of developing others as well (43).

Other autoimmune disorders that may accompany celiac disease include (44):

• rheumatoid arthritis
• ulcerative colitis
• Crohn’s disease
• multiple sclerosis
• Hashimoto’s disease
• Graves’ disease
• systemic lupus erythematosus

Summary

Untreated celiac disease may increase your risk of nutritional deficiencies, infertility, and bone loss. People with one autoimmune disorder may also be at a higher risk of developing others.

How to manage symptoms of celiac disease

Celiac disease is a lifelong condition that has no cure. However, people with this condition can manage their symptoms effectively by adhering to a strict gluten-free diet.

This means that you must avoid any products containing wheat, barley, rye, or spelt, including any foods that may have been cross-contaminated, such as oats, unless they’re labeled as gluten-free.

Foods to avoid

Here are a few other foods you should avoid unless they’re specifically labeled as gluten-free:

• pasta
• bread
• cakes
• pies
• crackers
• cookies
• beer
• dressings
• sauces
• gravies

Foods to eat

Fortunately, there are plenty of nutritious, naturally gluten-free foods. Cutting out processed foods, enjoying mostly whole foods, and reading food labels can make it much easier to follow a gluten-free diet.

Here are some foods to eat on a healthy gluten-free diet:

• meat, poultry, and seafood
• eggs
• dairy
• fruits
• gluten-free grains, such as:
  • quinoa
  • rice
  • buckwheat
  • millet
• vegetables
• legumes
• nuts
• healthy fats
• herbs and spices

If you suspect that you may have celiac disease, consult with a doctor to get tested and determine whether a gluten-free diet is necessary.

Be sure not to begin a gluten-free diet until you are tested for celiac disease, as it may skew your test results.

Summary

A gluten-free diet helps reduce symptoms of celiac disease. You’ll need to eliminate products containing wheat, barley, rye, and spelt, replacing them with whole foods that are naturally gluten-free.

The bottom line

Celiac disease is a serious condition that can cause a wide range of symptoms, including digestive issues, nutritional deficiencies, weight loss, and fatigue.

However, keep in mind that symptoms may vary between people with celiac disease. In fact, while some may experience a few of the symptoms listed above, others may not have any noticeable symptoms.

If you suspect you may have celiac disease, speak with your doctor about getting tested. For those with celiac disease, following a gluten-free diet can help manage and reduce these symptoms.

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