Celiac disease has wide range of possible symptoms.

Oral Signs:

• Bleeding gums
• Discolored Teeth
• Pale Mouth Sores

Skin:

• Dry skin
• Itchy Skin Rash

Gastrointestinal:

• Foul smelling bowel movements
• Diarrhea
• Constipation
• Bloating
• Gas
• Stools that stick to the toilet bowl

Bones:

• Bone pain
• Bone tenderness
• Thin Bones
• Delayed Growth
• Joint Pain
• Tingling/Numbness

Pyschological:

• Headaches
• Depression
• Irritability

Other:

• Infertility
• Fatigue
• Weight Loss
• Anemia
• Abdominal Bleeding

Fatigue and Weight Loss: The inability to absorb carbohydrates and fats may cause weight loss (or failure to thrive/stunted growth in children) and fatigue or lack of energy.

Anaemia: Anaemia may develop in several ways: iron malabsorption may cause iron deficiency anaemia, and folic acid and vitamin B12 malabsorption may give rise to megaloblastic anaemia.

Weak Bones: Calcium and vitamin D malabsorption (and compensatory secondary hyperparathyroidism) may cause osteopenia (decreased mineral content of the bone) or osteoporosis (bone weakening and risk of fragility fractures).

Abdominal Bleeding: A small proportion (10%) have abnormal coagulation due to deficiency of vitamin K, and are slightly at risk for abnormal bleeding.

Gastrointestinal: While celiac disease is primarily a bowel disease, bowel symptoms may also be limited or even absent.

The diarrhoea characteristic of celiac disease is pale, voluminous and malodorous. Abdominal pain and cramping, bloatedness with abdominal distention (thought to be due to fermentative production of bowel gas) and mouth ulcers may be present. As the bowel becomes more damaged, a degree of lactose intolerance may develop. However, the variety of gastrointestinal symptoms that may be present in patients with celiac disease is great, and some may have a normal bowel habit or even tend towards constipation. Frequently the symptoms are ascribed to irritable bowel syndrome (IBS), only later to be recognised as celiac disease; a small proportion of patients with symptoms of IBS have underlying celiac disease, and screening may be justified.

Celiac disease leads to an increased risk of both adenocarcinoma and lymphoma of the small bowel, which returns to baseline with diet. Longstanding disease may lead to other complications, such as ulcerative jejunitis (ulcer formation of the small bowel) and stricturing (narrowing as a result of scarring).

Malabsorption-related: The changes in the bowel make it less able to absorb nutrients, minerals and the fat-soluble vitamins A, D, E, and K.

Celiac disease is also associated with bacterial overgrowth of the small intestine, which can worsen malabsorption, or cause malabsorption after treatment.

Children: Children between 9 and 24 months tend to present with bowel symptoms and growth problems shortly after first exposure to gluten-containing products. Older children may have more malabsorption-related problems and psychosocial problems, while adults generally have malabsorptive problems. Many adults with subtle disease only have fatigue or anaemia.