Celiac Disease Symptoms and Causes

Celiac disease is an autoimmune reaction to eating gluten.

If you have celiac disease, eating gluten causes your body’s immune system to attack your small intestine. This damages the lining of your small intestine and prevents your body from absorbing required nutrients. Over time, untreated celiac disease can lead to malnutrition, intestinal damage, and other serious health complications.1

Celiac disease occurs in approximately 1 percent of the world’s population, but most people with the condition are undiagnosed.2 It can develop at any age, as some people develop it as children and others as adults. Celiac disease is an underdiagnosed, undermanaged condition associated with serious long-term complications, including the development of osteoporosis, neurologic disorders, gastric ulcers, and cancer (such as lymphoma).3,4 It often runs in families. If someone in your family has celiac disease, talk to your healthcare professional to see if you should also be tested for celiac disease.

Common Symptoms of Celiac Disease

If you have celiac disease, diagnosis may take time because the symptoms that people think of—diarrhea, weight loss, and bloating—are just part of the picture. Some people with celiac disease may exhibit other nondigestive symptoms, or sometimes people have no symptoms at all.3

Symptoms in Adults

More than half of adults with celiac disease have signs and symptoms that are not related to the digestive system, including:

  • Itchy, blistery skin rash (dermatitis herpetiformis)
  • Iron-deficiency anemia
  • Loss of bone density (osteoporosis)
  • Damage to dental enamel
  • Mouth ulcers
  • Headaches and fatigue
  • Joint pain
  • Acid reflux and heartburn
  • Missed menstrual periods
  • Infertility or miscarriage3

Symptoms in Children

Infants and children tend to experience digestive problems such as: 

  • Abdominal bloating and pain
  • Chronic diarrhea
  • Vomiting
  • Constipation

Children can also experience other nondigestive symptoms, including fatigue, irritability, behavioral issues, delayed growth and puberty, and failure to thrive.2,5

Common Celiac Disease Triggers

Wheat isn’t the only gluten-containing grain. Other culprits are barley, bulgur, rye, and seitan. And although oats don’t contain gluten, they are often processed in facilities that also produce gluten-containing grains, which means there's a risk for cross-contamination. So many people with celiac disease avoid oats as well.

Some common foods, drinks, and sauces that could contain gluten and trigger an autoimmune response in someone with celiac disease include:


Gluten can be hidden in many foods. That’s why it’s important to read food labels and ask about gluten before buying and eating food. Additional, perhaps surprising, examples of where you might find gluten include:

Gluten can also be found in nonfood items such as
 lipstick, lip gloss and lip balm, herbal and nutritional supplements, drugs and over-the-counter medications, vitamins and supplements, and play dough.

How do I know for sure?

If you’ve noticed that eating foods containing gluten causes problems, talk to your healthcare professional about getting tested. On average, it takes five to 11 years from symptom onset for celiac disease to be diagnosed.3 This is because many of the symptoms of celiac disease are so similar to other diseases, such as Irritable Bowel Syndrome (IBS), Irritable Bowel Disorder (IBD), and lactose intolerance. Similar symptoms that overlap between common intestinal conditions may mean that healthcare professionals might not consider testing for celiac disease right away.

Many people are so used to living with—and being embarrassed by—their uncomfortable gastrointestinal issues that they never consider asking for help. 

But learning what causes your symptoms now may also help you avoid more serious issues in the future. A missed or incorrect diagnosis of celiac disease can delay treatment and lead to an increased risk of other serious health complications including:

  • Bone disease, such as osteoporosis
  • Reproductive problems including infertility
  • Some intestinal cancers
  • Inadequate nutrient absorption
  • Delayed growth in children
  • Development of additional autoimmune diseases4


I think I may have celiac disease. 

Talk to your healthcare professional before trying a gluten-free diet. If you stop or even reduce the amount of gluten you eat before you're tested, it could change your test results and cause a misdiagnosis or a falsely negative test. If you think you or a loved one has a gluten-related disorder, don’t try to manage the problem on your own. A simple blood test—together with your medical history—can help your healthcare professional differentiate between allergy, celiac disease, and other conditions.

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  1. Celiac Disease Foundation. Long-Term Health Conditions. https://celiac.org/celiac-disease/understanding-celiac-disease-2/what-is-celiac-disease/24477-2/. Accessed September 2017.
  2. Lebwohl B, Ludvigsson JF, Green PHR. Celiac disease and non-celiac gluten sensitivity. The BMJ. 2015;351:h4347.
  3. Ruiz AR. Celiac disease. The Merck Manual website. www.merckmanuals.com. Updated May 2014
  4. Green PHR, Stravropoulos SN, Goldstein S, et al. Characteristics of adult celiac disease in the USA: results of a national survey. Am J Gastroenterol. 2001;96:126 -131
  5. Schuppan D, Zimmer KP. The Diagnosis and Treatment of Celiac Disease. Dtsch Arztebl Int. 2013; 110(49): 835–846.
  6. Celiac Disease Foundation. Sources of Gluten. https://celiac.org/live-gluten-free/glutenfreediet/sources-of-gluten/. Accessed September 2017.