Celiac disease presents with a wide range of symptoms, and the way it shows up can vary greatly between people. Common signs include digestive issues like chronic diarrhea or constipation, bloating, gas, abdominal pain, and malabsorption-related problems such as iron deficiency anemia, fatigue, and weight loss. Some people, especially adults, have non-digestive symptoms such as skin rashes (dermatitis herpetiformis), mouth ulcers, joint or bone pain, headaches, anxiety or depression, nerve issues, and reproductive concerns. In children, signs can also include delayed growth, short stature, and dental enamel defects. Because symptoms can overlap with many other conditions, diagnosis isn’t based on symptoms alone. If you’re wondering whether you might have celiac disease, consider the following steps:
- Track symptoms and risk factors: Note the frequency, duration, and types of symptoms (digestive and non-digestive), any family history of celiac disease or wheat allergies, and whether symptoms improve on a gluten-free diet or flare after gluten exposure.
- Screening tests (serology): A healthcare provider can order blood tests that look for specific antibodies (most commonly tissue transglutaminase IgA, sometimes total IgA and deamidated gliadin peptide antibodies). Abnormal results suggest celiac disease, but they typically require confirmation.
- Confirmation via biopsy: If blood tests are positive or highly suggestive, an upper endoscopy with a small intestine biopsy is often performed to confirm damage to the lining of the small intestine (villous atrophy) typical of celiac disease.
- Gluten-containing foods before testing: To avoid false negatives, it’s important to eat gluten-containing foods for several weeks before testing unless a doctor advises otherwise.
- Consider genetic testing: In some cases, testing for HLA-DQ2 or HLA-DQ8 can help rule out celiac disease—these genes are necessary but not sufficient for the condition.
Important cautions:
- Untreated celiac disease can lead to complications over time, including nutrient deficiencies, osteoporosis, infertility, and in rare cases certain cancers. Early identification and management are beneficial.
- A formal diagnosis is essential before starting a strict gluten-free diet; doing so prematurely can make testing less reliable.
What to do next:
- Schedule an appointment with a primary care clinician or gastroenterologist to discuss your symptoms, risk factors, and the possibility of testing.
- If you have severe symptoms such as dehydration, severe abdominal pain, vomiting with an inability to keep fluids down, or signs of anaphylaxis, seek urgent medical care.
If you’d like, describe your symptoms (what you’ve been experiencing, how long they’ve lasted, and any patterns), and I can help interpret what patterns are commonly associated with celiac disease and outline questions to ask your clinician.
