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. gastrointestinal symptoms of fat malabsorption include diarrhea malodorous flatulence (foul smelling gas) abdominal bloating and increased amounts of fat in the stool (steatorrhea). 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. loss of intestinal villi also causes malabsorption of carbohydrates particularly the sugar lactose. lactose is the primary sugar in milk. in celiac disease the intestinal villi along with the lactase enzymes on their surface are destroyed leading to malabsorption of lactose. signs and symptoms of malabsorption of lactose are particularly prominent in individuals with celiac disease who have underlying lactose intolerance a genetically determined reduction in the activity of lactase. symptoms of lactose malabsorption (diarrhea excessive flatulence [passing gas] abdominal pain and abdominal bloating or distension) occur because unabsorbed lactose passes through the small intestine and into the colon. 2. signs and symptoms of malnutrition and vitamin or mineral deficiencies weight loss and fluid retention: weight loss is the direct result of inadequate absorption of carbohydrates proteins and fat. however weight loss may not always occur because individuals with celiac disease often have an enormous appetite that compensates for the reduced absorption of nutrients. moreover weight loss can be masked by fluid retention. fluid retention occurs in advanced malnutrition because the reduced absorption of protein results in low protein levels in the blood. anemia: lack of absorption of vitamin b12 and iron can lead to anemia. osteoporosis: lack of absorption of vitamin d and calcium can lead to osteoporosis and bone fractures. easy bruising: lack of absorption of vitamin k can lead to diminished ability of blood to clot and hence to easy bruising or excessive bleeding. peripheral neuropathy (nerve damage): vitamin deficiencies of b12 and thiamine may contribute to nerve damage with symptoms of poor balance muscle weakness and numbness and tingling in the arms and legs. infertility: untreated celiac disease can lead to infertility in women lack of menses (menstruation) spontaneous abortions and low birth weight infants. muscle weakness: lack of absorption of potassium and magnesium can lead to severe muscle weakness muscle cramps and numbness or tingling sensations in the arms and legs.
what are the signs and symptoms of celiac disease?