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Symptoms of celiac disease: which are they and how to spot them

Celiac disease and gluten sensitivity

In this article we’re going to cover in the most exhaustive way possible which are the symptoms of celiac disease and how to recognize them. Starting with the usual “celiac disease is getting increasingly common” might sound trivial, but the number of people suffering from gluten intolerance is actually increasing.

First of all, you must know there is a huge difference between celiac disease and a simple gluten sensitivity. Here, we’re going to talk about symptoms of celiac disease, an autoimmune disease that mostly affects the intestine.

How to find out if you have celiac disease?

Let’s start by clarifying this: celiac disease is a disease of the digestive system that damages the small intestine, interfering with the absorption of nutrients.

People who suffer from it are intolerant to gluten, a protein found in cereals (wheat, spelt, barley, oat, rye, kamut, malt etc). Any type of food made from these foodstuffs contains gluten in smaller or larger amounts.

Traces of gluten are also found in other commonly used products, like many medicines and supplements. When people suffering from celiac disease consume gluten, their immune system reacts by damaging the intestinal villi (small protuberances of the intestinal mucosa responsible of absorbing nutrients).

If the villi are not working properly symptoms of malnutrition will appear, even if you keep eating regularly. Symptoms of celiac disease are among the most varied, often vary from person to person and can be mistaken for symptoms of other diseases. For this reason, getting to a definite diagnosis is not easy.

Celiac disease, symptoms and ailments: how to spot them

To be sure of being gluten intolerant, you need to proceed gradually and consider different factors: here are 6 steps to get a certain diagnosis. How is celiac disease manifested?

Celiac disease is diagnosed through specific tests, but there are some symptoms of gluten intolerance that should give us a warning of being intolerant. What are the symptoms of celiac disease? Unfortunately, symptoms of celiac disease can vary a lot, and often don’t develop, especially in adults.

Symptoms of celiac disease during adulthood are atypical: skin manifestations, mood issues, pain and cramps to the abdomen, constipation. Sometimes celiac disease is diagnosed in completely asymptomatic adults.

Symptoms of celiac disease in adults

Now let’s see in detail which are the ailments typical of celiac disease in adults, trying to analyze all the symptoms of it, since they can be confused with symptoms of other diseases.

Symptoms of typical celiac disease:

  • Abdominal swelling and pain
  • Bloating
  • Vomit
  • Diarrhoea
  • Light-coloured and foul-smelling stool
  • Slimming

Atypical symptoms of celiac disease:

  • Fatigue
  • Bone pain and fragility
  • Tingling in your limbs
  • Dermatitis
  • Depression

Don’t forget that there is a form of celiac disease that is almost completely asymptomatic (the most subtle one, because it might be discovered long after its onset, when damage is serious.

Which are the tests to diagnose celiac disease?

Sorbitol-based breath test

This test is required to diagnose malabsorption at intestinal level. To the patient are administered 5 grams of sorbitol (a sweetener) and then the concentration of hydrogen in the exhaled air is measured at regular intervals.

If the hydrogen concentration increases, this means sorbitol hasn’t been absorbed by the small intestine and has fermented in the colon, thus producing gas, including hydrogen. Intestinal malabsorption is a symptom of celiac disease, but also of other ailments, so if this test is positive, more tests will be required.

Stool test

Even this test can be useful to diagnose malabsorption syndromes, and to select patients to subject to further testing.
If the patient’s intestine fails to absorb nutrients, stool samples will contain excessive amounts of fats and acidic pH.

Symptoms of celiac disease on our body

A picture is worth more than a thousand words, that’s why we have provided a graphical representation of ailments and symptoms of celiac disease.

sintomi celiachia nonna paperina

Blood tests

Patients affected by celiac disease show high levels of some antibodies and autoantibodies (proteins that attack body cells and tissues). Blood tests will be carried out for:

  • anti-tissue transglutaminase
  • antiendomysial antibodies
  • anti-gliadin antibodies

If levels for these antibodies are higher than normal, the patient will have more than 95% probability of suffering from celiac disease, and will undergo more tests for further confirmation. A further question to our experts: Do celiac patients have low iron levels?

Anemy from lack of iron is indeed among symptoms of celiac disease. Some doctors prescribe colonoscopy with intestinal biopsy, others order a duodenal biopsy

Dermatitis herpetiformis among symptoms of celiac disease

15 to 25% of celiac patients suffer from this type of dermatitis, that causes appearance of blisters and severe itching. Usually it appears on elbows, knees and glutes, and is diagnosed through a skin biopsy.

If tests for celiac disease antibodies are positive, and the biopsy confirms the presence of this type of dermatitis, then the gluten intolerance will be extremely likely.

Perhaps not everyone knows that celiac disease may also manifest with dermatologic issues, not necessarily paired with intestinal symptoms. It’s called dermatitis herpetiformis, also known as DH or Duhring disease, which is nothing but a cutaneous manifestation of celiac disease.

Which is the relationship between dermatitis herpetiformis and celiac disease?

Severe itching, bubbles and blisters similar to herpes lesions (hence the name “herpetiformis”) that appear on both sides of the body, more frequently on forearms, near elbows, as well as on knees and glutes. It’s a permanent condition whose symptoms show up on and off, but can go into remission, usually with a strictly gluten-free diet.

DH affects 15 to 25% of people who suffer from celiac disease, and usually don’t show digestive symptoms. However, even without symptoms, some damage occurs in people affected by DH. It can affect people from all age groups, but more frequently it appears in subjects aged between 30 and 40. People of northern European descent are more likely to develop DH compared to people of Asiatic or African origins. It is slightly more common in men than in women.

Gluten sensitivity is usually genetic. Studies have been carried out on families suffering from celiac disease and DH, and they show how 5% of first-degree relatives of a person with DH will have DH as well. A further 5% of first-degree relatives of a person with DH will have celiac disease only, while a further 4% will develop other autoimmune diseases connected to DH, such as hypothyroidism. People are basically genetically predisposed to celiac disease.

Which are the causes of dermatitis herpetiformis? And the treatment?

Dermatitis herpetiformis is caused by an immunoglobulin-A deposit (IgA) on the skin, which triggers further immunological reaction, resulting in the formation of lesions. DH is an external manifestation to an abnormal immune response to gluten.

Treatment includes antibiotics to alleviate itching and a strict gluten-free diet. This means the patient won’t be able to eat, drink or take meds that contain wheat, rye, barley, oat and their derivatives.

A gluten-free diet is the only solution capable of effectively controlling dermatitis herpetiformis. In most cases, this treatment must be followed for 1-2 years to avoid any further DH outbreaks.

Intestinal biopsy to confirm symptoms of celiac disease

This is the only test that allows for a virtually certain diagnosis of celiac disease, and patients positive to tests listed above will be referred to it.

It’s performed by inserting a long and thin probe that is sent through the esophagus down until the stomach and first intestinal tract, where samples of mucose are taken to be analyzed in laboratories.

Since celiac disease damages intestinal villi by “flattening” them examining the mucose with a microscope allows to confirm or rule out this disease with virtually no margin of error.

Hoping we’ve been exhaustive; we close with a not too obvious recommendation. If you suspect to be suffering from celiac disease, please talk to your doctor, who will guide you step by step, referring you to the appropriate specialists and help you get a guaranteed diagnosis.

The 4 types of celiac disease

The 4 types of celiac disease: what you need to know. Celiac disease is an increasingly common problem. Gluten is the proteic component found in wheat and other cereals, such as wheat, barley, spelt, rye, bulgur and malt.

As you know, this is the life-changing protein, therefore we are faced with an autoimmune disease affecting the intestine, which can no longer process and absorb gluten, leading the body to treat it like toxic food.

The internal walls of the intestine are covered in villi, small protuberances that create loops required to absorb food nutrients. Effects of celiac disease cause a misreaction from villi that somehow tend to atrophy, thus flattening the mucose and preventing it from absorbing nutrients.  However, what we often don’t know is that there are 4 different types of celiac disease.

4 types of celiac disease that should not be underestimated

This disease can be categorized into 4 types: typical, atypical, silent and potential. The first, the typical one is the easiest to diagnose, because it manifests with diahorrea and strong abdominal pain.

In rare cases, you can have a different reaction, that is a chronic form of constipation. Anyways, the most evident symptom is weight loss and, if it occurs at an early age, it may actually lead to a growth stunt.

In atypical forms, there are related manifestations that, at first glance, are not always clearly linked to this disease. Among the most common, there is alteration of tooth enamel, frequent appearance of canker sores, some types of dermatitis and anemia. It’s not difficult to guess that the silent form is among the most difficult to diagnose, in adults and otherwise, because of the lack of clear manifestations.

However, even in these cases, the disease leads to non-trascurable damage to the intestine, namely villous atrophy, with immediate consequences in food absorption and growth.

Effects of celiac disease in latent forms

Finally, there is the possibility of a latent form of celiac disease. In this case, the body has no intestinal alterations, but rather a genetic predisposition. This means that possible future damage connected to celiac disease is not to be excluded. Therefore, in these cases regular checks are heavily recommended.

Simonetta Nepi (from “Gluten Free Travel e Living”) has also pointed out the existence of refractory celiac disease. This is a complication characterised by persistent malabsorption and villious atrophy that persists over time without improvement, although the gluten-free diet is implemented and carefully followed.

The solution for people suffering from celiac disease

Unfortunately, to this day there is no medical treatment against this autoimmune disease, even though there are many theories, ongoing studies and many discoveries were already made.

The only weapon to contrast symptoms of celiac disease, as well as evident, potential and future damage is an appropriate diet based on gluten-free products, as well as a positive attitude, since eating well, healthily, and with gusto is possible even in these situations!

Nowadays many trustworthy brands offer genuine and delicious products that can bring the best cuisine to the table while leaving gluten aside. We can find them at the grocery store and at specialized shops.

These companies offer a wide range of products for celiac people and food suitable to those who need a special diet, like athletes or people affected by specific forms of food intolerances.


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