Coeliac / Celiac Disease Symptoms - Full list
Coeliac / Celiac Disease Symptoms
One of the main issues with undiagnosed celiac and doctors not diagnosing coeliac disease . celiac disease (CD) is the vast array of relatively ‘minor' and major symptoms associated with the disease. I am sure that the TV program ‘House' will one day have a spell binding episode devoted to a patient in grave danger where he quickly saves the day. In the real world the plethora of associated symptoms listed in this article may assist those who are feeling a ‘bit off colour' to consider if they should be checked for the coeliac disease. And even less comforting is the fact that some people with CD report no symptoms at all.
Causes of Coeliac Disease
Another article on this site suggests that agricultural methods and manufacturing methods that have unnaturally increased the quantity of gluten in grains or increased it as an additive to many foods may have increased the rates of coeliac disease. However it can also be ‘triggered' by several methods indicated below.
"Celiac disease is both a disease of mal-absorption-meaning nutrients are not absorbed properly-and an abnormal immune reaction to gluten. Celiac disease is also known as celiac sprue, non-tropical sprue, and gluten-sensitive enteropathy. Celiac disease is genetic, meaning it runs in families. Sometimes the disease is triggered-or becomes active for the first time-after surgery, pregnancy, childbirth, viral infection, or severe emotional stress." Ref 4
" There is evidence that this reaction is partially genetic and inherited. Thus, approximately 10% of first-degree relatives (parents, siblings or children) of individuals with celiac disease also will have celiac disease. In addition, in approximately 30% of fraternal twins and 70% of identical twins, both twins will have celiac disease. Finally, certain genes have been found to be more common among individuals with celiac disease than among individuals without celiac disease. " Ref 4
Pre cursors to SYMPTOMS
At this point, it might be easier to explain what is not a symptom of coeliac disease. Because it is a malnutrition disease symptoms also vary from person to person and from children to adults and be difficult to pinpoint.
Another article has suggested that there is evidence that "The length of time a person was breastfed, the age a person started eating gluten-containing foods, and the amount of gluten-containing foods one eats are three factors thought to play a role in when and how celiac disease appears. Some studies have shown, for example, that the longer a person was breastfed, the later the symptoms of celiac disease appear." Ref 2
Symptoms also vary depending on a person's age and the degree of damage to the small intestine.
Signs and symptoms of mal-absorption "The three major categories of dietary nutrients are carbohydrates, proteins, and fat. Absorption of all of these nutrients can be reduced in celiac disease; however, fat is the most commonly and severely affected nutrient. Most of the gastrointestinal symptoms and signs of celiac disease are due to the inadequate absorption of fat (fat mal-absorption). Gastrointestinal symptoms of fat mal-absorption include diarrhoea, malodorous flatulence (foul smelling gas), abdominal bloating, and increased amounts of fat in the stool (steatorrhea). The unabsorbed fat is broken down by intestinal bacteria into fatty acids, and these fatty acids promote secretion of water into the intestine, resulting in diarrhea. Fatty stools typically are large in volume, malodorous (foul smelling), greasy, light tan or light grey in color, and tend to float in the toilet bowl. Oil droplets (undigested fat) also may be seen floating on top of the water." Ref 4
"Loss of intestinal villi also causes mal-absorption of carbohydrates, particularly the sugar lactose. Lactose is the primary sugar in milk. Lactose is made up of two smaller sugars, glucose and galactose. In order for lactose to be absorbed from the intestine and into the body, it must first be split into glucose and galactose. The glucose and galactose then can be absorbed by the cells lining the small intestine. The enzyme that splits lactose into glucose and galactose is called lactase, and it is located on the surface of the small intestinal villi. In celiac disease the intestinal villi along with the lactase enzymes on their surface are destroyed, leading to mal-absorption of lactose." Ref 4
Coeliac Disease SYMPTOMS
Coeliac disease symptoms can be roughly sorted into the following categories: ‘minor symptom', major symptom, children symptoms. By minor, I mean not immediately life threatening and so likely to be put up with by a person for a longer period which may delay diagnosis even further.
There are two categories of signs and symptoms: 1) signs and symptoms due to mal-absorption, and 2) signs and symptoms due to malnutrition including vitamin and mineral deficiencies.
Alphabetical ‘minor' symptoms
- Abdominal cramping/bloating Abdominal distension - "occur because unabsorbed lactose passes through the small intestine and into the colon."
- Appetite (Increased to the point of craving)
- Back pain (Such as a result of collapsed lumbar vertebrae)
- Bruising easily - Lack of absorption of vitamin K
- Decreased ability to clot blood
- Diarrhoea (See Stools below)
- Electrolyte depletion
- Energy loss
- Flatus (Passing gas) - caused by unabsorbed lactose passes through the small intestine and into the colon where normal bacterium split the lactose and produce hydrogen and methane as a by product.
- Feet (Reduced fat padding)
- Gluten ataxia
- Lactose intolerance
- Missed menstrual periods
- Mouth sores or cracks in the corners
- Muscle cramping (Especially in the hands and legs) and muscle weakness caused by poor absorption and low levels of potassium and magnesium. This can lead to severe muscle weakness, muscle cramps, and numbness or tingling sensations in the arms and legs.
- Night blindness
- Skin (Very dry)
- Stools - irregular composition such as: Loose, Hard, Small, Foul smelling, Gray-coloured etc.
- Tongue (Smooth or geographic - looks like different continents)
- Tooth enamel defects
- Vitamin K Deficiency
- Weakness in general
- Weight loss - can be masked by fluid retention caused by reduced absorption of protein
More severe & longer term complications
- Arthritis - Bone or joint pain
- Anaemia - through Lack of absorption of vitamin B12 and iron
- Dermatitis herpetiformis - blistering, intensely itchy skin. The rash has a symmetrical distribution and is most frequently found on the face, elbows, knees and buttocks.
- Diabetes type 1
- Fatigue and chronic fatigue syndrome
- Infertility or recurrent miscarriage and spontaneous miscarriages
- Peripheral Neuropathy - nerve damage caused by Vitamin deficiencies of B12 and thiamine. Symptoms include poor balance, muscle weakness, and numbness and tingling in the arms and legs.
- Osteoporosis or bone loss
- Sjogren's Syndrome
- Thyroid Disease
- Tingling numbness in the hands and feet
CHANGES or prolonged negative EMOTIONAL STATE
- Disinterested in normal activities
- Mood changes
- Unable to concentrate
Celiac Disease SYMPTOMS IN CHILDREN
Because children have been exposed to gluten for a shorter period of time the symptoms are often smaller in number. However they can be very severe such as ‘slow development' including not gaining weight or losing weight. Often the symptoms can often be mis-diagnosed as a general bowel disorder or IBS rather than CD. The common factor is that these symptoms typically occur after introduction of gluten-containing cereals into their diets.
Under three years of age specific signs may be: growth failure; diarrhoea; projectile vomiting; abdominal bloating/ distension.
Older children may suffer from: crankiness; difficulty in concentrating; irritability; personality changes; poor memory
Latent and silent celiac disease
The terms latent and silent celiac disease are used to refer to patients who have inherited the genes that predispose them to celiac disease but have not yet developed the symptoms or signs of celiac disease. Latent celiac disease refers specifically to patients who have abnormal antibody blood tests for celiac disease but who have normal small intestines and no signs or symptoms of celiac disease. Ref 4
It is obvious from a cursory glance at this article that the effects and symptoms caused by CD can be far reaching, life altering and life threatening. That is why being correctly diagnosed as soon as possible if you even vaguely consider someone may have this disease is very important.
Ref 1 http://celiac-disease.com/what-are-the-symptoms-of-celiac-disease/
Ref 2 http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/
Ref 3 http://www.csaceliacs.org/celiac_symptoms.php
Ref 4 http://www.medicinenet.com/celiac_disease/article.htm