What are the signs and symptoms of celiac disease?
Depending on the degree of malabsorption, the signs and symptoms of celiac disease vary among individuals, ranging from no symptoms, few or mild signs and symptoms, to many or severe signs and symptoms. There are two categories of signs and symptoms: 1) signs and symptoms due to malabsorption, and 2) signs and symptoms due to malnutrition including vitamin and mineral deficiencies.
1. Signs and symptoms of malabsorption
The three major categories of dietary nutrients are carbohydrates, proteins, and fat. Absorption of all of these nutrients can be reduced in celiac disease; however, fat is the most commonly and severely affected nutrient. Most of the gastrointestinal symptoms and signs of celiac disease are due to the inadequate absorption of fat (fat malabsorption). Gastrointestinal symptoms of fat malabsorption include diarrhea, malodorous flatulence (foul-smelling gas), abdominal bloating, and increased amounts of fat in the stool (steatorrhea). The unabsorbed fat is broken down by intestinal bacteria into fatty acids, and these fatty acids promote secretion of water into the intestine, resulting in diarrhea. Fatty stools typically are large in volume, malodorous (foul smelling), greasy, light tan or light grey in color, and tend to float in the toilet bowl. Oil droplets (undigested fat) also may be seen floating on top of the water.
