The signs and symptoms of the disease are determined by the intestinal damage and by the consequences of the malabsorbtion. The most usual symptoms of celiac disease are: diarrhea, vomiting, weight loss, fatigue, and abdominal distension, but even though this disease is primarily an intestinal disorder, bowel symptoms may be subtle or absent. In some cases the diagnosis may be rather based on symptoms determined by the malabsorbtion . For example in subtle disease, the adults may only complain of fatigue and their blood tests show a mild anemia and the children may have psychologiacal problems and malabsorbtion-related disturbances.
T he diarrhea is a very characteristic sign of celiac disease and it usually manifests as the presence of voluminous, discolored and malodorous stools. The cramping, bloatedness accompanied by abdominal distension (determined by the gas resulted from fermentation processes) abdominal pain and lesions on the mucous membrane lining the inner side of the cheeck are other common features of celiac disease. As the disease progresses and the intestine is more affected, lactose intolerance may occur. The gastrointestinal symptoms may be various and some patients may have a normal intestinal tranzit or even display a tendency towards constipation.
Celiac disease may lead to other intestinal disorders such as stricturing or ulcerative jejunitis or it may increase th risk of developing adenocarcinoma and lymphoma.
As a consequence of the impaired intestinal absorbtion other disturbances may also occur determined by the deficit in vitamins, calcium, and nutrients. Weight loss may occur in adults due to the insufficient amount of aminoacids, glucose and fats absorbed and in children stunted growth and pubertal delay are determined by this form of malnutrition. The malabsorbtion of calcium may lead to osteopenia, osteomalacia and osteoporosis, affecting the bone metabolism and increasing the risk of fractures. Anemia may be determined by more than one cause, all related to the impaired absorbtion function: by the malabsorbtion of iron there will occur iron deficiency anemia and the malabsorbtion of vitamin B12 and folic acid will lead to megaloblastic anemia.
At the moment the only effective treatment consists in a gluten-free diet. Nevertheless there are people with refractory disease whose condition does not improve after taking the dietary measures. In these cases the treatment with corticosteroids should be considered.