When you think about the symptoms of coeliac disease, you probably think of the typical gut symptoms. These include severe or occasional diarrhoea, excessive wind and/or constipation, along with recurrent stomach pain, cramping or bloating.

However, one study published in the British Medical Journal, showed that less than 50% of coeliac patients experienced these ‘classic’ symptoms. Although gut symptoms are seen as standard for coeliac disease, they are not always present. When it comes to being diagnosed with coeliac disease, people who are experiencing non-gut symptoms have been found to outnumber those with the expected gut related issues.

What are the non-gut symptoms of coeliac disease to look out for, and what should you do if you experience these symptoms?

Ten non-gut symptoms of coeliac disease

1. Cognitive issues – some people with undiagnosed coeliac disease report difficulty focusing or concentrating. This is sometimes referred to as ‘brain fog’, and can also result in headaches or migraines, balance issues and even psychological issues like anxiety or depression.
2. Fatigue – one of the most common symptoms of coeliac disease is fatigue, due to the lack of absorption of essential nutrients, vitamins and minerals. Some coeliac patients experience fatigue without any associated gut problems.
3. Skin problems – skin issues associated with coeliac disease can range from mild itching and rashes to dermatitis herpetiformis. These symptoms are most common on the scalp, knees and elbows.
4. Bone and joint issues – poor absorption of calcium and vitamin D can lead to skeletal problems such as sore joints and frequent fractures. Left untreated, coeliac disease can lead to osteoporosis, where the bones become porous, weak and brittle.
5. Blood problems – similarly, lack of absorption of iron in the gut can lead to anaemia. This can present as breathlessness, fatigue and general weakness as the blood is not able to carry oxygen as effectively.
6. Fertility issues – nutritional issues caused by coeliac disease can affect the hormones, leading to a number of fertility issues, including an increased risk of miscarriage.
7. Delayed puberty – disturbed hormone levels can also result in a delay to puberty and irregular periods when puberty does arrive.
8. Growth issues – malnutrition, as a result of poor nutritional absorption, can lead to delayed growth in children, in terms of both weight and height, and to unexplained weight loss in adults.
9. Oral problems – coeliac disease can produce problems in the mouth, including persistent ulcers that occur regularly and are slow to heal. Lack of calcium can also affect the quality of tooth enamel.
10. Peripheral tingling – coeliac disease can cause a tingling sensation in the fingers and toes, known as peripheral neuropathy.

How common are non-gut symptoms of coeliac disease?

Non-gut symptoms of coeliac disease are surprisingly common. One review of medical records found that 68% of patients diagnosed had ‘symptoms not typically associated with coeliac disease’.

These figures go some way towards explaining why as many as 70% of people with coeliac disease remain undiagnosed.

What should I do if I have non-gut symptoms of coeliac disease?

If you are experiencing any of the symptoms listed above,, you should ask your GP to be tested for coeliac disease. This is especially important if you have a first-degree relative (parent, child or sibling) who has the condition.

The symptoms may not be caused by coeliac disease, but it is always worth checking. The treatment of following a strict gluten free diet can be very effective in easing or curing these symptoms.

The Glutafin online symptom checker is a useful tool to help you to decide if you should ask for a test for coeliac disease.

Spot the symptoms and start feeling better sooner

Coeliac disease is a complex condition that changes the way your body absorbs nutrients from your food. As a result, it can affect a wide range of bodily systems and manifest in many different ways.

While ‘classic’ gut-related symptoms are what most people think of, it is equally important to be aware of the other signs and symptoms of coeliac disease. That way you can get diagnosed with coeliac disease sooner, and start on the road to recovery.

Frequently asked questions about non-gut symptoms of coeliac disease

Q. Can I have coeliac disease with no gut pain?

A. Yes. Some studies show that less than 50% of coeliac patients exhibit ‘classic’ gastro-intestinal symptoms.

Q. Can coeliac disease cause brain fog?

A. Yes. Nutritional issues caused by poor absorption can cause difficulty concentrating or focusing, memory issues, headaches, anxiety and even depression.

Q. How does coeliac disease affect fertility?

A. Lack of iron and other nutrients, due to poor absorption, can affect hormone levels leading to infertility, miscarriage, delayed puberty and irregular periods.

Q Can I have coeliac disease with no symptoms?

A. Yes. It is estimated that around 20% of patients with coeliac disease have no symptoms at all.

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