Celiac Disease Signs & Symptoms

  • People with celiac disease cannot tolerate gluten, a protein in wheat, rye, and barley. Gluten is found mainly in foods but may also be found in everyday products such as medicines, vitamins and lip balms.

  • When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging or destroying villi — the tiny, fingerlike protrusions lining the small intestine that allow nutrients to be absorbed into the bloodstream. This view of the small intestine shows the normal surface pattern — a series of ridges and finger like projections.

  • In celiac disease the surface pattern of the small intestine mucosa becomes flattened developing a mosaic-like pattern of crypt openings.

  • Celiac disease symptoms vary from person to person. Digestive symptoms are more common in infants and young children and may include abdominal pain, chronic diarrhea, vomiting, constipation and weight loss.

  • Adults are less likely to have digestive symptoms and may instead have one or more of the following: iron deficiency anemia, fatigue, bone and joint pain, arthritis, osteoporosis, depression, seizures, missed menstrual periods, infertility, recurrent miscarriage, canker sores, or an itchy rash called dermatitis herpetiformis (pictured).

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    People with celiac disease have higher than normal levels of certain autoantibodies. Blood tests to detect high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA) may be performed to diagnose celiac disease. Patients should continue to eat a diet that includes foods with gluten prior to testing to prevent false-negative test results.

  • When a patient’s symptoms and blood tests suggest celiac disease, clinicians may perform a biopsy of the small intestine using an endoscope to confirm the diagnosis to check for damage to the villi. This electron micrograph of the small intestinals shows the surface is abnormally flat due to the loss of villi.

  • The only treatment for celiac disease is a gluten-free diet, which consists of avoiding foods that contain wheat, rye, and barley. Patients with celiac disease should not eat most grain, pasta, cereal and many processed foods. For most patients, eating a gluten-free diet will stop symptoms within a few days, heal existing intestinal damage, and prevent further damage.

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More than 2 million people in the United States have celiac disease – a digestive disorder caused by an abnormal immune reaction to gluten.

Because celiac disease symptoms vary greatly and are similar to other diseases, such as intestinal infections, IBS, anemia diverticulitis and chronic fatigue syndrome, the disorder can be difficult to diagnose.

But as health care providers become more aware of the many varied symptoms of the disease and as more reliable blood tests become available, diagnosis rates are increasing. Learn more about celiac disease with this slideshow.

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