The variety of celiac disease signs and symptoms is almost unbelievable, and they mimic the signs and symptoms of many other diseases. Some are gastrointestinal (GI), while others are extraintestinal (meaning in parts of the body outside of the GI tract).
According to the National Foundation for Celiac Awareness (NFCA):
There are more than 300 symptoms of celiac disease, and symptoms may vary among different people.
One person might have diarrhea and abdominal pain, while another person has irritability or depression. Some patients develop celiac symptoms early in life, while others feel healthy far into adulthood. Some people with celiac disease have no signs or symptoms. (1)
At the end of the article is a list of complications from untreated celiac disease. In a sense, these can be the most serious celiac disease signs that progress over time.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), researchers are finding that the following factors can play a role in the onset and variability of celiac disease signs and symptoms: (2)
For example, breastfeeding appears to be protective against celiac disease because the longer a person was breastfed, the later in life symptoms appear.
NIDDK also states that: “Symptoms also vary depending on a person's age and the degree of damage to the small intestine. Many adults have the disease for a decade or more before they are diagnosed. The longer a person goes undiagnosed and untreated, the greater the chance of developing long-term complications.” (2)
The following study demonstrates the variability of celiac disease signs and symptoms, as well as the finding that most celiacs have non-classical celiac disease, a form of the disease that presents without the signs and symptoms of malabsorption.
Over a 15-year period in one hospital in Bologna, Italy, 770 patients were diagnosed with celiac disease. In the 610 symptomatic patients (79%), those with non-classical celiac disease outnumbered patients with classical celiac disease (66% versus 34%).
The classical symptom of diarrhea was found in 27% of patients. Non-classical symptoms of the GI tract included “bloating (20%), aphthous stomatitis [canker sores or mouth ulcers] (18%), alternating bowel habit (15%), constipation (13%), and gastroesophageal reflux disease [GERD] (12%).”
Moreover, “Extraintestinal manifestations included osteopenia/osteoporosis (52%), anemia (34%), cryptogenic hypertransaminasemia [elevation of a certain group of liver enzymes] (29%), and recurrent miscarriages (12%).” (3)
A short list of celiac disease signs and symptoms includes diarrhea, constipation, abdominal pain, indigestion, bloating, gastroesophageal reflux disease (GERD), and other GI complaints.
Some people with celiac disease have no GI symptoms, although they have positive blood tests and small intestinal damage characteristic of celiac disease.
Some of the signs and symptoms of celiac disease that can occur outside of the GI system include chronic fatigue, iron deficiency anemia, unexplained weight loss, infertility, osteoporosis, and depression.
Here's a long list of celiac disease signs and symptoms, grouped by category and compiled from a variety of reputable sources.
Autoimmune diseases (in addition to celiac disease) occur 3 to 10 times more often in people with celiac disease than in the general population. (3) Autoimmune diseases associated with celiac disease include the following:
Other conditions associated with celiac disease include the following:
As of a study published in 2007, only 3%–5% of individuals with celiac disease are diagnosed in the United States. That means that a lot of people with untreated celiac disease are walking around having no idea of the serious and potentially fatal consequences ahead of them—unless they get diagnosed and begin a gluten-free diet. (4)
According to the NCBI Bookshelf report on celiac disease, “Overall, persons with untreated or unresponsive celiac disease have increased early mortality compared to the general population, mainly because of the higher rate of malignancies. This risk is highest in the year after initial diagnosis, likely because of a prolonged period of unrecognized symptoms associated with celiac disease.”
The following lists the possible complications of untreated celiac disease (the first four are types of cancer):
1. Celiac disease symptoms list. Beyond Celiac. [Article]
2. Symptoms and causes of celiac disease. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Jun 2016. [Article]
3. Pagon RA, Adam MP, Ardinger HH, et al., editors. Celiac Disease. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993–2016. [Chapter]
4. Collin P, Huhtala H, Virta L, Kekkonen L, Reunala T. Diagnosis of celiac disease in clinical practice: physician’s alertness to the condition is essential. J Clin Gastroenterol. 2007;41:152–156. [Abstract]
Celiac Disease Awareness Campaign of the National Institutes of Health
Celiac Disease Foundation
Children's Hospital of Chicago
GeneReviews® from the University of Washington, Seattle
Beyond Celiac (formerly National Foundation for Celiac Awareness (NFCA))
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Southern Arizona Celiac Support
University of Chicago Celiac Disease Center
World Gastroenterology Organisation