Celiac Disease

Learn the warning signs and symptoms of celiac disease in adults and children, and discover how changes in your diet can lead to dramatic improvements in the quality of your life.

Celiac Disease in Adults: Signs, Diagnosis & Treatment

A delayed diagnosis means delayed treatment, which increases the risk of developing added health complications. But knowing and identifying symptoms of celiac disease in adults can pave the way to a prospective diagnosis and enhance overall health and quality of life.

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Celiac disease impacts an estimated 1 in 133 Americans, or about 1 of the population, according to Beyond Celiac. However, an estimated 83 percent of Americans who have celiac disease are undiagnosed or misdiagnosed with other conditions.

What’s more, the average length of time for a symptomatic person to be diagnosed with celiac in the U.S. is four years. A delayed diagnosis means delayed treatment, which increases the risk of developing added health complications.

But knowing and identifying symptoms of celiac disease in adults can pave the way to a prospective diagnosis and enhance overall health and quality of life.

What is Celiac Disease?

Also known as coeliac disease, celiac sprue, non-tropical sprue, and gluten sensitivity enteropathy, celiac disease is an autoimmune disorder characterized by an abnormal response to ingested gluten.

Gluten is a protein found in a variety of grains that helps foods maintain their shape and acts as the glue to hold food together. When individuals with celiac disease consume gluten, it disturbs the gastrointestinal (GI) tract and the "toxic" fragments stimulate an immune response. Essentially, the body believes and comprehends gluten is a harmful substance, thus attacking its own GI lining.

The exact etiology of celiac disease is not well-known. What health experts do know, though, is that celiac disease occurs from genetic, food, and other environmental factors. The condition is embedded as an inherited, predisposed risk factor that surfaces based on numerous reasons, including early childhood infections, gut bacteria, and seasons in which the baby was born.

Interestingly, celiac disease may even become triggered for the first time following surgery, pregnancy, childbirth, stress, or an infection. Additional risk factors for celiac disease include family history, type 1 diabetes, autoimmune thyroid disease, and rheumatoid arthritis.

Signs and Symptoms of Celiac Disease in Adults

According to the Celiac Disease Foundation, there are more than 200 known celiac disease symptoms which may occur in the digestive system or other parts of the body. Signs of celiac disease also vary between children and adults.

Classic symptoms of celiac disease include diarrhea, abdominal pain and bloating, nausea and vomiting, gas, steatorrhea (fat in the stool), indigestion and heart burn.

Digestive symptoms are more likely in children, though can also occur in adults. Celiac disease symptoms in adults also include:

• Dermatitis Herpetiformis: Dermatitis herpetiformis is an itchy, blistering skin rash mostly affecting the knees, elbows, and buttocks regions.

• Peripheral Neuropathy: Peripheral neuropathy is the result of damage to peripheral nerves, which can cause tingling, numbness or pain in the hands and feet.

• Anemia: Damage to the small intestine interrupts the absorption of micronutrients, including anemia-related iron, vitamin B-12, and folate. Oftentimes first witnessed as an iron deficiency, symptoms frequently include fatigue, hair loss, and easy bruising.

• Brittle Bones: When damage to the digestive tract occurs, absorption of calcium and vitamin D may also be disrupted. Inefficient absorption of the two vitamins and minerals ultimately increases the likelihood of weak, brittle bones. This raises the risk of osteoporosis.

• Lactose Intolerance: Though milk products are naturally gluten-free, damage to the small intestine reduces the ability of lactose (the natural sugar found in milk and most dairy products) to be efficiently absorbed. Eliminating lactose-containing products may also limit calcium and vitamin D, further increasing the risk of bone loss.

• Enamel Damage: Damage to the enamel may be a consequence of unmanaged celiac disease, especially if and as malnutrition becomes more prominent. Enamel plays a major role in teeth protection and damage to it can ultimately hinder good dental health.

• Mouth Ulcers: Resembling those infamous "canker sores," mouth sores related to celiac disease commonly occur at random. Whitish sores on the tongue and cheeks along with present enamel damage can help verify celiac mouth sores.

• Joint Pain: If dealing with conjoined rheumatoid arthritis (RA) and celiac disease or a gluten sensitivity, eliminating or reducing gluten intake can ease joint pain. Even without an arthritic diagnosis, joint pain may still be likely to arise.

• Mood and Anxiety Disorders: Celiac disease has been associated with an increased risk of depression and anxiety.

• Infertility: Both men and women can face infertility, involving a reduction in sexual desire and function. Women may have abnormal menstrual cycles and recurrent miscarriages.

Diagnosing and Treating Celiac Disease

The diagnosis process of celiac disease is multifaceted. Initially, recognizing symptoms of celiac disease often provokes individuals to wonder whether or not they have the condition. An antibody test and intestinal biopsy is needed to solidify a true celiac diagnosis.

If an individual does not test positive for celiac disease, a gluten sensitivity or intolerance may be issued. Gluten sensitivities often provoke similar symptoms to celiac disease, including gas, diarrhea, and abdominal pain. However, a sensitivity will generally not result in severe nutritional deficiencies, cause organ damage, or increase the risk of other health conditions.

Eliminating gluten is the only known treatment for celiac disease. Following a gluten-free diet can be achieved by knowing which foods to avoid and which are considered safe to eat.

Foods to Avoid:

The Celiac Disease Foundation denotes the following gluten-containing grains and their derivatives include:

• Wheat

• Varieties and derivatives of wheat, including durum, einkorn, emmer, farina, farro, graham, semolina, spelt, and wheat berries

• Rye

• Barley

• Triticale

• Malt in various forms, such as malted barley flour, extract, and syrup

• Brewer's yeast

• Wheat starch

• Oats*

*While oats are naturally gluten-free, they are often manufactured with gluten-containing products and become contaminated.

Unless tested and labeled as "gluten-free," avoid the following foods on a gluten-free diet:

• Cereals

• Breads

• Pastas

• Crackers

• Pastries

• Vinegars

• Sauces

• Dressings

• Gravies

• Candies and candy bars

• Malted beverages, including beers and malted milkshakes

Gluten may also be hidden in cosmetics, hygiene products, supplements, and prescription drugs.

Foods to Eat:

Though gluten is widely distributed across the food supply, there is an abundance of food that is deemed safe. These foods are naturally devoid of gluten:

• Gluten-free grains, including amaranth, corn, millet, quinoa, rice, and sorghum

• Fresh fruits and vegetables

• Meat and poultry products

• Nuts and seeds

• Legumes

While removing gluten from the diet can improve signs of celiac disease, doing so prematurely can interfere with lab results and lead to an inaccurate diagnosis. That being said, never self-diagnosis celiac disease and remove gluten without a definitive answer.

Furthermore, removing gluten without professional guidance can provide a host of consequences, particularly related to potential reduction of fiber, B vitamins, and other nutrients naturally-sourced from most gluten-containing foods. 

Always consult with a doctor or dietitian to help formulate an individualized plan to help meet personal needs safely. Utilizing a gluten-free meal delivery service can also help ensure a safe eating plan.

Written By Sydney Lappe, MS, RDN. Published on November 07, 2012. Updated on August 06, 2019.

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