Could I Have Celiac Disease?

You’ve been bloated for years. You’ve tried cutting dairy, then cutting carbs, then eating more fiber, then eating less. You’re also tired in a way a good night’s sleep doesn’t touch, and your doctor said it’s probably IBS. Maybe it is.

What it can look like in adults

The NIDDK¹ lists bloating, chronic diarrhea, constipation and gas, and also fatigue, joint or bone pain and headaches. It says digestive symptoms are more common in children than in adults, so an adult’s picture can look different, with more symptoms outside the gut.

The NHS² lists diarrhoea, stomach aches, bloating, flatulence, indigestion and constipation, plus tiredness from not getting enough nutrients from food and unintentional weight loss.

For women, the NIDDK¹ says celiac disease can cause reproductive problems, including infertility, a delayed start of periods, missed periods or repeated miscarriages. If your cycle is unpredictable, see late or irregular periods.

It also says people with celiac disease who have no symptoms can still develop complications over time if they aren’t treated. That’s why testing exists.

What it’s often mistaken for

The symptom list overlaps with IBS, dairy intolerance and constipation. A test can tell them apart. Guessing can’t.

Who should ask about testing

The NHS² says testing is usually recommended only for people who have symptoms or an increased risk. The NIDDK³ says doctors in the US do not routinely screen everyone, and that blood relatives of people with celiac disease and people with type 1 diabetes should talk with their doctor about whether to be tested.

How it’s diagnosed, and the one thing not to do first

The NIDDK³ says blood tests can show antibody levels that are often higher in people with untreated celiac disease, and biopsies of the small intestine taken during an endoscopy can confirm it.

One step matters before any other. The NIDDK³ says doctors don’t recommend starting a gluten-free diet before diagnostic testing, because it can affect the results. Keep eating your usual diet until your clinician says otherwise.

What treatment looks like

The NHS² says following a gluten-free diet should help control symptoms and prevent long-term complications, and that even if you have mild symptoms, changing your diet is still recommended, because continuing to eat gluten can lead to serious complications. A dietitian can help with the details, and Coeliac UK offers resources if you’re in the UK.

The play

Try this: a symptom-and-meal log, before you change anything

For three weeks, keep eating normally and write down what you ate, bowel habits, bloating, energy, headaches, joint pain, and your period dates.

Add your family history, including any relative with celiac disease or type 1 diabetes.

Take the log to your appointment and ask whether celiac testing makes sense.

When to get checked

Book an appointment if any of these fit:

• Bloating, diarrhea or constipation that has lasted for weeks or months
• Fatigue that has no clear cause
• Unintentional weight loss
• Joint or bone pain or headaches along with digestive symptoms
• Missed or delayed periods, or trouble getting pregnant, with digestive symptoms
• A close relative with celiac disease, or you have type 1 diabetes

Bloating that never gets a clear answer is a reason to ask for the test. Ask first, and keep eating gluten until you’ve had it.