What are the signs and symptoms of celiac disease?
The symptoms of celiac disease differ between individuals, with some people only showing minimal symptoms that can easily go undiagnosed, while others are severely affected. Regardless of the extent of the symptoms, the damage to the intestinal lining still occurs in celiac-affected people. The symptoms of celiac disease include gastrointestinal symptoms, as well as many other non-gastrointestinal symptoms.
The gastrointestinal symptoms of celiac disease are the symptoms that are most commonly associated with this disease. Many affected people experience embarrassing flatulence and uncomfortable bloating and often feel as though they have overeaten. Constipation and diarrhea are common symptoms, with pale stools that can be fatty and/or bloody. An excessive weight loss may occur, as the body is unable to absorb nutrients (including fats). Or sometimes people gain weight, due to overeating to compensate for the lack of nutrient absorption. Appetite changes and nausea and vomiting are also common symptoms of celiac disease. The serious damage that occurs in the intestine of affected people can also lead to other food sensitivities, including lactose intolerance.
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If celiac-affected people are not diagnosed and continue to consume gluten, serious damage occurs in the intestine, preventing the absorption of nutrients and leads to further non-gastrointestinal symptoms. Sometimes these non-gastrointestinal symptoms can occur in the absence of the gastrointestinal symptoms detailed above, which can further complicate an accurate diagnosis. Fatigue is a common symptom often combined with painful migraines, irritability, depression and anxiety. Musculoskeletal problems including muscle cramps and joint pain can also occur. Skin rashes, known as dermatitis herpetiformis, affect some people. These red, itchy rashes generally occur on the elbows, knees, bottom and back, and can cause a painful burning sensation. The poor absorption of nutrients can also lead to serious vitamin deficiencies, low iron levels (anemia) and low blood sugar (hypoglycaemia). Other symptoms of celiac disease can include nosebleeds, hair loss, seizures, mouth ulcers, dental enamel defects, missed menstrual periods and a tingling in the legs or feet due to low calcium and nerve damage. When celiac disease occurs in children, the poor absorption of nutrients can also lead to attention deficit disorder, decreased growth and development and delayed puberty
If celiac disease is undiagnosed for an extended period and gluten is still consumed, serious and irreversible damage to the intestinal lining can occur, leading to further health complications. Osteoporosis is a common complication due to the decreased ability to absorb nutrients such as calcium. It is thought that the immune response that damages the intestine also leads to bone damage. Frail, brittle bones characterize osteoporosis and affected people often suffer from broken bones. Celiac disease can lead to infertility and miscarriages or birth defects due to the poor absorption of folic acid. Other autoimmune disorders (e.g. diabetes, lupus and rheumatoid arthritis) and other organ damage (e.g. kidney, liver and heart problems) have also been linked to celiac disease. Intestinal cancer may also occur in severely affected people.