What are the symptoms of celiac disease?
Symptoms may begin at any age after gluten is introduced in the diet. Intestinal symptoms include chronic diarrhea or constipation, bloating and gas, irritability, and poor weight gain. Patients may have growth and pubertal delay, iron deficiency anemia, fractures or thin bones, abnormal liver tests, and a chronic itchy rash called dermatitis herpetiformis. Symptoms of celiac disease vary or may occur without symptoms. Damage to the small intestine begins before symptoms develop. The following is a list of most of the signs and symptoms that are associated with celiac disease in children. It should be noted that not all signs and symptoms occur with each chld.
- Diarrhea or, more rarely, constipation
- Foul-smelling stool
- Decreased appetite
- Weight loss or failure to gain weight
- Slowed growth
- Anemia or decreased oxygen-transporting material in the blood causing fatigue
- and pale complexion
- Abdominal distension
- Abdominal pain in some cases
- Decreased muscle mass in the limbs
- Damage to tooth enamel or failure of enamel formation
- Delayed puberty
- Itchy skin rash known as dermatitis herpetiformis (more common in adults
How is celiac disease diagnosed?
A diagnosis of celiac disease means the individual must stay on a strict gluten free diet for life. Following such a diet strictly is not always easy as there are many hidden sources of "gluten". A gluten free diet may also involve added cost to the individual and impact their quality of life. Therefore it is essential that your physician confirm the diagnosis before recommending life long adherence to the diet.
Celiac disease may go undiagnosed for years. Blood tests are widely used to test for celiac disease. Both the anti-tissue transglutaminase antibody (tTG) and the anti-endomysial antibody (EMA) tests are highly accurate and reliable but are insufficient to make a diagnosis. Celiac disease must be confirmed by finding certain changes to the villi which line the small intestine. To see these changes, a tissue sample from the small intestine is obtained, using a procedure called an endoscopy with biopsy. (A flexible tube-like instrument is placed through the mouth, down the throat, past the stomach and into the small intestine to obtain small tissue samples).
Failure to treat an individual with celiac disease carries potential adverse long term health consequences involving both increased morbidity and mortality