What Are the Symptoms of Celiac Disease in Adults?

Celiac disease can lead to various symptoms due to intestinal damage. In fact, there are more than 200 known celiac disease symptoms.

Celiac disease is an immune reaction to eating gluten, a protein found in wheat, barley, and rye. Celiac disease is also known as:

• Celiac sprue
• Gluten intolerance
• Gluten-sensitive enteropathy
• Nontropical sprue

If you have celiac disease, eating foods that contain gluten causes an immune response in your small intestine. This immune response damages your small intestine's lining and prevents it from absorbing some nutrients (malabsorption) over time.

The intestinal damage caused by celiac disease can lead to various symptoms. In fact, there are more than 200 known celiac disease symptoms. Some people develop celiac disease as a child, others as an adult. The reason for this is still unknown. Digestive signs and symptoms of celiac disease in adults include:

Diarrhea

Loose, watery stools are common in individuals with celiac disease. Dehydration is a dangerous side effect of diarrhea.

Fatigue

Fatigue is described in many ways, from feeling weak to being tired or simply lacking energy.

Weight loss

Weight loss often refers to a loss of body fat, but in cases of severe weight loss, protein, and other substances in the body may also decrease.

Bloating and gas

Bloating causes the feeling that your stomach is larger or fuller than normal. Gas, or flatulence, occurs when intestinal gas is passed from the anus.

Nausea and vomiting

Nausea is the uncomfortable feeling that you need to vomit, but it doesn't always lead to vomiting. Vomiting is the forcible emptying of the stomach’s contents through the mouth, also known as "throwing up."

Constipation

You may be constipated if you pass fewer than three stools per week. Severe constipation is diagnosed when someone passes zero to one stool per week.

Dermatitis herpetiformis

This skin disease, which celiac disease may trigger, causes blistering and itchiness. It usually presents on the elbows, knees, torso, scalp, and buttocks.

According to the World Gastroenterology Organization, there are two types of celiac disease: classical and non-classical.

If you have classical celiac disease, symptoms include diarrhea, steatorrhea (pale, foul-smelling, fatty stools), and weight loss.

If you have non-classical celiac disease, you may experience abdominal pain, bloating, and other mild gastrointestinal symptoms not related to malabsorption. You may also experience symptoms such as iron-deficiency anemia, chronic fatigue, chronic migraine, tingling, numbness or pain in your hands or feet, elevated liver enzymes (hypertransaminasemia), reduced bone mass or bone fractures, unexplained infertility, dermatitis herpetiformis, and more.

The reason for celiac disease is still unknown, though it is most likely a combination of genetics and diet. Some people develop celiac disease as a child, others as an adult.

If you have celiac disease, the immune response in your small intestine damages the tiny, finger-like structures of tissue, called villi, that line your small intestine. These villi absorb vitamins, minerals, and other nutrients from food.

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 (X chromosome is missing partially or fully)
• Autoimmune thyroid disease
• Microscopic colitis (lymphocytic or collagenous colitis)
• Addison's disease (adrenal glands produce too little cortisol)

Celiac disease affects people differently, making it difficult to diagnose. Two blood tests can help diagnose celiac disease:

• Serology testing looks for elevated levels of certain antibody proteins
• Genetic testing for human leukocyte antigens (HLA-DQ2 and HLA-DQ8)

If the results of these tests show signs of celiac disease, your doctor may perform one of two confirmation tests:

Endoscopy

This method uses a tiny camera on a long tube. It's inserted through the mouth and passed down the throat — also called an upper endoscopy. The camera is used to get a clear view of your small intestine. Your doctor will also take a small tissue sample, called a biopsy, from your small intestine.

Capsule endoscopy

A capsule endoscopy uses a tiny wireless camera to take pictures of your entire small intestine. The camera sits inside a vitamin-sized capsule, which you swallow. As the capsule travels through your digestive tract, the camera takes thousands of pictures that are transmitted to a recorder.

Unfortunately, the only available management for celiac disease is a gluten-free diet. Removing gluten from your diet will gradually reduce inflammation in your small intestine, causing you to feel better and eventually heal.

Foods to avoid that contain gluten include:

• Barley
• Bulgur
• Durum
• Farina
• Graham flour
• Malt
• Rye
• Semolina
• Spelt
• Triticale
• Wheat

Traces of gluten are sometimes found in some medications, supplements, and preservatives. Your doctor might recommend steroids to control inflammation if your small intestine is severely damaged. Steroids can help ease severe signs and symptoms of celiac disease while your small intestine heals.