HomeAnswersInternal Medicinemalabsorption syndromeDo my symptoms suggest celiac disease?

Do my symptoms suggest celiac disease?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At August 26, 2016
Reviewed AtJuly 25, 2023

Patient's Query

Hello doctor,

I have always had weird symptoms and I think I have celiac disease. I also think that the combination of all my symptoms may mean something. I was tested once for thyroid problems and once for Lyme disease because I had a big, dangerous tick-bite rash. I am 19 years old and according to my growth curve (height of father and mother) my height should be 1.80 meters. I started puberty later than everyone else my age. I have always been too short, I am 1.68 meters now and I do not think that I will grow any longer. I am also feeling tired and sleepy all day long. I thought it was because of school and other stuffs and I just need some rest. But now during my holidays, though I have slept around 8-10 hours every day, I feel tired and sleepy. My black circles also did not disappear.

My symptoms are as follows. I have signs of anemia, such as rapid heartbeat, headache, dizziness, pale skin through which veins can be seen and had little cracks at the corners of the mouth some years ago. I use to get sudden muscle spasms once per day or so. Since birth, I have been suffering from asthma and acid reflux. I have small individual red spots on torso, joint, bone and muscle pain for a few times a day and it does not hurt too badly. I have pop elbows for a year or so. I am getting pale sores in the mouth and bad teeth. I brush twice a day with an electric brush, but still many problems when I go to the dentist. I feel bloated and constipation. My stools are of bad smell and oily. I am also getting diarrhea a few times per week. I got hereditary hair loss and bald temples. I have a history of migraine including temporary blind spots in sight. Occasionally, I get strange things in eyesight, not only normal floaters, but sometimes also hundreds of very fast moving transparent balls. Sometimes, I suddenly see a very flashy thing in my eyesight for a few seconds. It takes long for me to fall in sleep after going to bed. I had intestinal problems all my life, but I just thought that they were normal. When I was very young, I did not really have so many issues like I have now. When I was around 14 years old, many of the problems started. I actually ended up in the hospital, because I had an unbearable pain under my ribs (right lower quadrant). They thought that I had a perforated cecum, but luckily that was not the case. They did not really know what it was, but I had high fever and I threw up 20 times or so. Around 17 years old, I started balding. Strangely the migraine has gone, but instead I have more signs of anemia. I eat a decent and good amount of vegetables and fruits. What do you guys think? Is it celiac disease or something else?

Answered by Dr. Sadaf Mustafa

Hello,

Welcome to icliniq.com. Thank you for sharing your detailed history with us. There is a very strong possibility that you have malabsorption syndrome. There are various types of malabsorption syndromes and celiac disease is one of them. You have signs of multiple essential nutrient deficiencies, including iron and vitamin B12, which can all happen with celiac disease and others. I would suggest getting a CBC (complete blood count), iron profile, vitamin B12 and vitamin D levels. Also, let us obtain screening investigations such as fecal fat content, IgA endomysial antibody (EMA) and tissue transglutaminase antibodies (tTG-IgA) to check for malabsorption and celiac disease. I am also considering autoimmune diseases like SLE (systemic lupus erythematosus) or mixed connective tissue disorder. But, I need more history to get a conclusion. Do you have any joint pain, oral ulcers and morning stiffness? If yes, then for how long?

Patient's Query

Thank you doctor,

I used to get oral ulcer around twice a year. I do not think it as morning stiffness, although my elbows make hard noises sometimes in the night, if I wake up. I have joint pains in legs, arms and hands. My hip feels locked sometimes and that also goes for my elbow and they make a pop sound.

Answered by Dr. Sadaf Mustafa

Hello,

Welcome back to icliniq.com. Welcome back to icliniq.com. Thank you for updating me with the further history and for the kind compliments. Based on the symptoms you described, it seems less likely to be rheumatoid arthritis or SLE. One possibility I am considering is Behcet's disease, although it typically involves genital ulcers as well. Let's proceed with the investigations I previously requested, as oral ulcers could also be linked to folic acid and iron deficiency. It's important to keep in mind that a gluten-free diet is the treatment of choice for celiac disease, and starting it before these investigations may alter the results and lead to false negatives. If the results come back positive, it might provide us with a conclusive answer. However, if they are negative, a colonoscopy with biopsy may be necessary as a definitive method for diagnosis.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sadaf Mustafa
Dr. Sadaf Mustafa

Internal Medicine

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