likely erupt in a loud, unabashed, confident chorus of “diarrhea, diarrhea, diarrhea!”
Yet most people with celiac disease or gluten sensitivity don’t have diarrhea. In fact, they don’t have any gastrointestinal symptoms at all! And if they do have gastrointestinal symptoms, they’re often constipated, or they suffer reflux or gas and bloating.
Gluten sensitivity and celiac disease have hundreds of symptoms. The following sections list some of the more common ones, starting with the symptoms that are gastrointestinal in nature.
The gastrointestinal symptoms of gluten sensitivity and celiac disease are vast. Although most people think diarrhea is the most common symptom, gastrointestinal symptoms can include constipation, gas, bloating, reflux, and even vomiting.
These are some of the “classic” – though not the most common – symptoms of celiac disease:
✔ Abdominal pain and distension
✔ Acid reflux
✔ Bloating
✔ Constipation
✔ Diarrhea
✔ Gas and flatulence
✔ Greasy, foul-smelling, floating stools
✔ Nausea
✔ Vomiting
✔ Weight loss or weight gain
Celiac disease and gluten sensitivity are gastrointestinal conditions because the damage is done to the small intestine. But people more commonly have what are called extraintestinal (outside the intestine) symptoms. These make up an extensive list of more than 250 symptoms, including the following:
✔ Fatigue and weakness (due to iron-deficiency anemia)
✔ Vitamin and/or mineral deficiencies
✔ Headaches (including migraines)
✔ Joint or bone pain
✔ Depression, irritability, listlessness, and mood disorders
✔ “Fuzzy brain” or an inability to concentrate
✔ Infertility
✔ Abnormal menstrual cycles
✔ Dental enamel deficiencies and irregularities
✔ Seizures
✔ Ataxia (bad balance)
✔ Nerve damage (peripheral neuropathy)
✔ Respiratory problems
✔ Canker sores (aphthous ulcers)
✔ Lactose intolerance
✔ Eczema/psoriasis
✔ Rosacea (a skin disorder)
✔ Acne
✔ Hashimoto’s disease, Sjögren’s syndrome, lupus erythematosus, and other autoimmune disorders
✔ Early onset osteoporosis
✔ Hair loss (alopecia)
✔ Bruising easily
✔ Low blood sugar (hypoglycemia)
✔ Muscle cramping
✔ Nosebleeds
✔ Swelling and inflammation
✔ Night blindness
Kids who have celiac disease tend to have the “classic” gastrointestinal symptoms of diarrhea or constipation. They may also have some of the following symptoms that aren’t gastrointestinal in nature:
✔ Inability to concentrate
✔ Irritability
✔ ADD/ADHD or autistic-type behaviors
✔ Failure to thrive (in infants and toddlers)
✔ Short stature or delayed growth
✔ Delayed onset of puberty
✔ Weak bones or bone pain
✔ Abdominal pain and distension
✔ Nosebleeds
Considering Your Options for Testing
With such an overwhelming assortment of symptoms, it’s no wonder people are often misdiagnosed before finding out that they have celiac disease or gluten sensitivity. It’s also no wonder so many people go undiagnosed.
A Reader’s Digest article titled “10 Diseases Doctors Miss” cited celiac disease as one of the top-ten misdiagnosed diseases. In all fairness to the medical community, it can be tough to diagnose celiac disease when you think of the myriad symptoms. Headaches, fatigue, infertility, depression – if you go to your doctor for any of those things, it’s unlikely that he or she is going to say, “Hmm, you’re depressed. Let’s test you for celiac disease.” No, it’s far more likely that you’ll be given an antidepressant and sent on your way.
Don’t despair. Plenty of doctors are extremely knowledgeable about these conditions and will do proper testing. If yours isn’t one of those, keep looking until you find one who is. There are even some tests that you can order yourself without a doctor’s intervention.
It seems like there should be one single test you can take that would definitively determine whether you have gluten sensitivity, celiac disease, or none of the above. But alas, it’s not that simple.
For one thing, there are different types of tests: blood, stool, saliva, and intestinal biopsy. In most cases, one type of test may determine whether you have celiac disease or gluten sensitivity – but most tests don’t discern between the two or test for both. In other words, one test looks for gluten sensitivity but not celiac disease; another looks for celiac disease but not gluten sensitivity. And most people only get one (maybe two) of those tests, so they’re rarely tested for both conditions.
So which test is best? Sounds like a simple question, but there’s no simple answer. The gold standard for testing for celiac disease is a blood test followed by an intestinal biopsy. If both tests are positive, you’re deemed to be confirmed as having celiac disease.
What can be said for certain – or close to it – is that if you test positive for celiac disease, you have celiac disease. That’s because the tests for celiac disease are very specific, highly sensitive, and extremely reliable – especially when they indicate a positive outcome (diagnosis of celiac disease).
However, if the test is negative and your symptoms go away on a gluten-free diet, then you probably have some form of gluten sensitivity.
Unfortunately, there are false negatives and occasional false positives.
