Symptoms and co-occuring diseases with celiac

Celiac disease presents in so many different ways that is has become known as something of a clinical chameleon. Due to the nonspecific symptoms, celiac disease is often diagnosed late or sometimes not even considered.

The symptoms of classical celiac disease usually begin between the first and third years of life.

Signs of celiac disease in children and adults:

  • Bloated belly (for small children, this presents with thin arms and legs, as well as wrinkles around the buttocks)
  • Diarrhea or large, clay-colored stool
  • Stomach pain
  • Loss of appetite
  • Weight loss
  • Muscle weakness
  • Behavior changes (for children, extreme emotional distresss or sadness)

For children, in particular, a strikingly serious iron deficiency often indicates celiac disease, in addition to an overall lack of vitality.

Symptoms of celiac disease in younger children are as follows: 

  • Indigestion
  • Stomach pain
  • Bloating
  • Changes in stool
  • Insomnia
  • Fatigue
  • Emotional distress
  • Hematoma
  • Edema
  • Anemia
  • Osteoporosis
  • Changes in tooth enamel
  • Unpleasant tingling in hands or feet including painful "pins and needle" or numbness sensations

Sometimes, abnormal blood work, such as slightly elevated transaminase levels or abnormal thyroid levels can indicate celiac disease.

Additionally, the number of patients that are diagnosed with celiac as a result of digestive tract complaints is decreasing, while the number of celiac patients detected by screenings of risk groups is increasing. These risk groups include patients with other autoimmune diseases such as diabetes or thyroid disorders, as well as relatives of individuals with celiac disease.

Celiac disease (gluten intolerance) has a strong genetic component

If a person's first-degree relative (parents, children) or second-degree relative (siblings, grandparents, grandchildren) has been diagnosed with celiac, it's recommended that the individual also take a blood test for transglutaminase antibodies. In such family screenings, physicians often discover symptom-free celiac patients. Even in these cases, patients should adhere strictly to a gluten-free diet since celiac disease involves an increased risk of other diseases, including: 

Strict avoidance of gluten minimizes the risk of co-morbidity and other complications.

In most cases, the small intestine of individuals with celiac disease is severely damaged at the time of diagnosis. This can lead, temporarily, to further intolerances, the most common being lactose intolerance and fructose malabsorption. These temporary intolerances have two causes: first, the damaged intestinal wall is not able to produce the necessary enzymes and transport molecules to a sufficient degree; second, the reduced intestinal surface plays a role – in the healthy state, the small intestine has an enormously large surface. So-called intestinal villi protrude intro the intestine, and the villi, in turn, are occupied by so-called microvilli, protuberances of the cell membrane which further enlarge the surface of the intestine. Nutrients from the intestine enter the blood stream because of this enlarged surface. When the intestines are inflamed, the microvilli, or in the worst cases even the villi, recede and the surface of the small intestine is thus drastically reduced. Over the smaller area, the body can absorb fewer substances via the intestinal wall.

Chances of recovery with celiac disease (gluten intolerance)

In the vast majority of cases, affected individuals only need to avoid lactose and fructose in the early days. When the intestines have had time to regenerate, most patients tolerate dairy products and fructose-containing foods again. Gluten intolerance, however, will remain forever, as celiac is an incurable autoimmune disease.

Further reading: 

What is celiac disease (gluten intolerance)?

Diagnosing celiac disease (gluten intolerance)

Treatment for celiac disease / what can I still eat?