What are the symptoms of celiac disease?

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Symptoms of Celiac Disease

Gastrointestinal Symptoms of Celiac Disease

Celiac disease, a chronic immune-mediated enteropathy triggered by gluten ingestion, primarily affects the small intestine and manifests with a variety of gastrointestinal symptoms. Common gastrointestinal symptoms include chronic diarrhea, abdominal pain, bloating, gas, and steatorrhea (fatty stools) . These symptoms result from the maldigestion and malabsorption of nutrients due to the damage inflicted on the intestinal mucosa by the immune response to gluten .

Weight Loss and Nutritional Deficiencies

Weight loss is a frequent symptom of celiac disease, often accompanied by malnutrition and deficiencies in essential vitamins and minerals . This is due to the impaired absorption capabilities of the damaged small intestine. Anemia, particularly iron-deficiency anemia, is also common and can be a presenting symptom in many patients .

Extraintestinal Manifestations

Celiac disease is not limited to gastrointestinal symptoms; it also presents with a wide range of extraintestinal manifestations. These include:

Dermatological Issues: Dermatitis herpetiformis, an intensely pruritic skin rash, is a well-known extraintestinal manifestation .
Oral Manifestations: Patients may experience recurrent aphthous stomatitis, atrophic glossitis, enamel defects, delayed dental eruption, and xerostomia.
Bone and Joint Pain: Osteoporosis, arthritis, and bone pain are common due to malabsorption of calcium and vitamin D .
Neurological Symptoms: Neurological issues such as gluten ataxia, peripheral neuropathy, and other neuropsychiatric features can occur .
Endocrine Disorders: Conditions like type 1 diabetes mellitus and thyroiditis are associated with celiac disease .

Atypical and Asymptomatic Presentations

Many individuals with celiac disease may present with atypical symptoms or may be asymptomatic. Atypical symptoms can include abnormal liver function tests, unexplained infertility, short stature, delayed puberty, and persistent iron deficiency anemia . Asymptomatic individuals are often diagnosed through screening, especially if they belong to high-risk groups such as first-degree relatives of celiac patients or individuals with associated autoimmune conditions .

Conclusion

Celiac disease presents with a broad spectrum of symptoms, ranging from classic gastrointestinal issues like diarrhea and abdominal pain to various extraintestinal manifestations such as dermatitis herpetiformis, anemia, and neurological symptoms. The disease can also present atypically or be asymptomatic, making diagnosis challenging. Early recognition and diagnosis are crucial to manage symptoms effectively and prevent long-term complications through a strict gluten-free diet.