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  • Jefferson Adams
    Jefferson Adams

    Twenty-One Diseases Commonly Confused with Celiac Disease

    Reviewed and edited by a celiac disease expert.

      Celiac disease is often confused with these other diseases, which can delay diagnosis.


    Caption: Image: CC BY 2.0--Andreasgh

    Celiac.com 11/07/2019 - Despite major improvements in awareness and testing, it can still take years to get a proper celiac disease diagnosis, in part because other diseases can cloud the issue. Often, doctors suspect, or even diagnose, other diseases before the patient's celiac disease is revealed. It’s easy for doctors, and even patients, to simply stop with one of these other diagnoses, causing unnecessary delays in a celiac diagnosis.

    Celiac disease is often confused for one or more of these twenty-one diseases. In many cases, patients can get one or more diagnoses for these conditions before finally being diagnosed with celiac disease. People with one or more of these conditions might want to get screened for celiac disease, especially if they have any celiac-related symptoms. 

    Here are twenty-one diseases commonly suspected or diagnosed before celiac disease is discovered:

    1. ALLERGIES

      Many people find themselves wrongly diagnosed with environmental allergies long before they are diagnosed with celiac disease. 
    2. CANKER SORES

      Study data published in BMC Gastroenterology indicate that aphthous stomatitis, commonly called canker sores, can be the sole symptom for about one in twenty people with celiac disease, so it makes sense to perform celiac screening these people. Anyone with canker sores and any of the myriad symptoms of celiac disease would be advised to check for celiac disease.
    3. LACTOSE INTOLERANCE

      Lactose intolerance is a common condition. In some cases, people discover their lactose intolerance after their celiac diagnosis. That’s because mucosal damage from gluten can leaves celiac patients unable to digest lactose. This can last until the gut fully heals, and many different foods may trigger adverse symptoms until full healing occurs. Some people see their lactose intolerance improve and even vanish after adopting a gluten-free diet. Probably, their gut is healed thoroughly enough that they no longer react. However, if you suspect celiac disease and are diagnosed with lactose intolerance, then consider pressing for a celiac disease screen, just to be sure. Especially if you still have symptoms after going dairy-free.
    4. IBS/IBD


      It’s been recently reported that celiac disease is uncommon in people with irritable bowel syndrome, so there's no need for routine celiac testing in IBS patients. However, for a proper diagnosis of IBS, it’s important to first rule out the presence of celiac disease. For this reason, anyone suspecting IBS should get checked for celiac disease, just to be sure.
    5. MENTAL ISSUES

      Many people with celiac disease suffer from mental issues, or psychiatric disorders such as anxiety and depression. We also know that a gluten-free diet can help to relieve some symptoms of schizophrenia. In some cases, especially in those without classic celiac symptoms, these psychiatric disorders can be among the few symptoms, and can make celiac disease difficult to diagnose. Moreover, many doctors attribute symptoms of celiac disease to psychosomatic causes. That is, they think it’s all in the patient’s head. Anyone who suffers from mental health issues along with celiac disease symptoms should probably get checked out for celiac disease.
    6. THYROID DISEASE

      Thyroid disorders are common in people with celiac disease. People with celiac disease have much higher rates of autoimmune thyroid disease than the regular population. For this reason, anyone diagnosed with autoimmune thyroid disease should be screened for celiac disease just to be sure.
    7. GALLBLADDER DISEASE
      It is not uncommon for people with celiac disease or gluten intolerance to have their symptoms attributed to gall bladder disease. Occasionally, this can lead to removal of the gall bladder, which may not result in symptom improvement. Anyone with celiac-associated symptoms who receives a diagnosis of gall bladder disease might want to get screened for celiac disease, just to be sure.
    8. AMOEBA/PARASITE/INFECTION

      Celiac disease symptoms can mirror symptoms of certain gut parasites, which is one reason that many people with celiac disease find themselves being checked for parasites long before they get checked for celiac disease.
    9. COLITIS/SPASTIC COLON

      Another common culprit for misdiagnosis is colitis, which shares many symptoms with celiac disease. Similarly, many people who actually have celiac disease find themselves with a diagnosis of “spastic colon.” 
    10. ACID REFLUX/GERD

      People with GERD don't have any higher rates of celiac disease than the rest of the population. However, to be fair, a pretty high percentage of newly diagnosed celiac patients have reflux and/or esophageal dysmotility; which might explain the high prevalence of reflux symptoms in celiac disease patients, and the common misdiagnosis of GERD. If your symptoms persist, consider getting checked out for celiac disease.
    11. PSYCHIATRIC DISORDERS

      In many cases, celiac disease symptoms can be so hard to pin down that doctors find themselves wondering if the symptoms aren't really in the patient's head. In their quest for diagnosis, many people with celiac disease have been referred to a psychologist, rather than evaluated for celiac disease.
    12. CHRONIC FATIGUE

      For these reasons, it’s important for patients diagnosed with anemia, especially unexplained anemia, to be checked out for celiac disease. Also, anyone with unexplained fatigue might want to press their doctor for a celiac disease screen. Many people with celiac disease report recurrent fatigue as one of their symptoms. Sometimes, fatigue can be one of the few or only symptoms, making celiac disease difficult to diagnose. Fatigue can be caused by low-iron, which can be a sign of anemia. Often, though, doctors simply diagnose anemia as the cause of the problem, rather than seeing it as a potential sign of celiac disease.
    13. WEIGHT GAIN

      Classic celiac disease patients commonly suffered weight loss or low body weight. That has changed. These days, it is much more common for patients with normal or high BMI to have celiac disease. There’s also some evidence that obesity plays a major role in triggering autoimmune disease. For these reasons, physicians should not discount the possibility of celiac disease based solely on BMI. 
      Screening Versus Symptoms: Does Detection Method Affect Body Mass For Celiacs on a Gluten-Free Diet?
      How can I be overweight with Celiac?
    14. CYSTIC FIBROSIS

      Cystic fibrosis is another disease with some symptoms, such as big appetite but poor weight gain, and bulky, smelly, greasy bowel movements, that can sometimes be blamed for celiac disease. Rates of celiac disease are about triple for patients who also suffer from cystic fibrosis, compared to those without cystic fibrosis. That’s why it’s important that people diagnosed with cystic fibrosis receive a screen for celiac disease. 
    15. DIABETES

      Numerous studies have shown connections between celiac disease and diabetes. In fact, researchers have found that celiac disease often precedes Type 1 diabetes in children with both conditions, and that up to 10% of children with Type 1 have clinical celiac disease. For this reason, it’s a good idea for people with diabetes to be screened for celiac disease, especially if they are suffering any type of celiac-associated symptoms.
    16. STRESS

       Also, there’s some evidence for a strong correlation between childhood stress and trauma, and the presence of celiac disease in adults.  Being diagnosed with a stress-related disorder, such as post-traumatic stress disorder, acute stress reaction, adjustment disorder, and other stress reactions, was significantly associated with an increased risk of autoimmune disease, compared with matched unexposed individuals. For these reasons, it’s important for people with celiac-like symptoms, who receive a diagnosis of stress, to be checked out for celiac disease.
    17. ANEMIA

      We also know that doctors are likely primary care physicians are likely under-testing for celiac disease in patients with iron deficiency anemia. For these reasons, it’s important for patients diagnosed with anemia, especially unexplained anemia, to be checked out for celiac disease. We know that celiac disease is common in cases of unexplained iron-deficient anemia. Read more on Anemia and Celiac Disease
    18. VIRUS (VIRAL GASTROENTERITIS)

      Another very common thing doctors suspect long before they suspect celiac disease, is viral gastroenteritis.
    19. CANCER/LYMPHOMA

      Certain types of cancer and/or lymphoma are strongly associated with celiac disease. For example, patients with celiac disease over five years showed higher rates of non-Hodgkins lymphoma, small-intestinal cancer, colon cancer, and basal cell carcinoma of the skin. That’s why it’s important for people with such types of caner/lymphoma be screened and evaluated for celiac disease. 
    20. SKIN CONDITIONS

      Having celiac disease can leave people at much greater risk for various skin conditions. People diagnosed with one of the following seven skin conditions commonly associated with celiac disease might want to consider getting checked out for celiac disease.
    21. PELLAGRA

      Pellagra is a disease caused by low levels of niacin, also known as vitamin B-3. It's marked by dementia, diarrhea, and dermatitis, also known as “the three Ds.” Because the symptoms of diarrhea and skin rash are similar, pellagra can be mistaken for celiac disease. Pellagra is easily treated with niacin supplements, but it's crucial that it is treated, otherwise it can be fatal. The two conditions can also co-exist, so anyone who is receiving enough niacin, but still presents celiac-like symptoms should likely be checked out for celiac disease.  

    Edited by Jefferson Adams


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    Guest Elaine Hoffmann

    Posted

    First I was told to cut out dairy. That didn't help. Then I was diagnosed with osteoporosis. Next was severe anemia. Then malabsorption. Finally, they figured out that it was celiac disease. That journey took seven years. I felt better after being gluten free for two weeks.

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    I was diagnosed, finally,  after having a biopsy of my intestine. My doctor's knowledge was amazing.  Prior to seeing him, I had unnecessary surgeries and was treated as my pain and sickness were all in my head.   My anemia and very low iron brought attention to my doctor to perform the biopsy.  I understand the suffering so many of us have gone through before properly diagnosed as I was 66 years old when diagnosed with Celiac disease. 

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    Fortunately. I had a pain in my stomach that was so horrible I just wanted to (if I could) pull out my stomach). After I got to the ER, I was seen by the doctor who gave me a Prevacid infusion. He sa ou d the pain could be my gallbladder,  pancreas, or appendix. When he said my appendix, I realized he didn't know what he was talking about.  I absolutely no appendix symtoms.

    Anyway,  he advised I see a gastrointestinal physician (that made sense). When I got an appointment. an Endoscopy was performed and I was diagnosed. 

    Looking back,  the sleepiness after eating a sandwich. Spaghetti and meatballs, pizza, and the like, I was always falling asleep or feeling tired although it may have been 1:00 in the afternoon. 

    I had issues such as falling for no reason and diagnosed with Polymioditus (inflammation of muscle tissue) which explained the weakness and falls. 

    My CPK level was off the charts (5000, 8000, and as high as 15 000) however,  my muscle strength was exceptional. The Rheumatologists I'd seen couldn't figure that out.

    I could write about the symptoms and medications I had been prescribed so I will not use this forum to put it all down. I will say the bandaid of MANY meds I was prescribed was Prednisone. (60 mg per day) it took a year to taper to 1mg then zero. So much more to add , but not sufficient space. 

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    Think about it:

    1. When did you first hear the word "gluten"?

    2. When did you first see gluten free anything in the grocery store?

    1 in 70 Australians have celiac disease.  It is becoming wide-spread and there is no stopping it.

    The ginny is now out of the bottle so to speak!

     

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    I had 7 of these diagnosis over a 20 plus year period often diagnosed by symptoms only. 

    I second the appendix poster above as well. As one time it was thought to be appendix , further testing showed it was not. I am glad they further investigated that one and I have my appendix today. Oh also asthma too I would add can be another misdiagnosis some Drs said I had asthma, but I never used my initially prescribed  inhaler.

    In my 40s is when my 4th immunologist and team confirmed it was gluten. Now the other 7-9 celiac symptoms that were diagnosed as other issues sit in the piles of my medical records.🤦

    Thank you Dr. that took the time to test. I wish I met you sooner, but I am glad I met you in time for midlife.

     

     

    Edited by Awol cast iron stomach
    Autocorrect incorrect

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    I WAS diagnosed with celiac disease about four years ago. This is after my gallbladder surgery. Stomach bloated and cramping. Headaches all the time. Feeling sleepy and iron low b12 low. Couldn’t never understand I was either having diarrhea or constipation. Never in the middle. Itching all over. Then finally I had a upper and lower done. And blood work done. Then you still get cross contaminated. I just need help fixing that. Cause I have a 8 year old. And he is constantly getting my things. Didn’t know there was gluten in that much stuff. What do y’all do to help with cross contamination. And bloating 

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    2 hours ago, Guest Amanda said:

    I WAS diagnosed with celiac disease about four years ago. This is after my gallbladder surgery. Stomach bloated and cramping. Headaches all the time. Feeling sleepy and iron low b12 low. Couldn’t never understand I was either having diarrhea or constipation. Never in the middle. Itching all over. Then finally I had a upper and lower done. And blood work done. Then you still get cross contaminated. I just need help fixing that. Cause I have a 8 year old. And he is constantly getting my things. Didn’t know there was gluten in that much stuff. What do y’all do to help with cross contamination. And bloating 

    This is an excellent article. To Amanda: According to NIH, there are many essential vitamins/minerals that Celiacs don't absorb. Try a nutritarian diet. 

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    2 hours ago, Guest Amanda said:

    I WAS diagnosed with celiac disease about four years ago. This is after my gallbladder surgery. Stomach bloated and cramping. Headaches all the time. Feeling sleepy and iron low b12 low. Couldn’t never understand I was either having diarrhea or constipation. Never in the middle. Itching all over. Then finally I had a upper and lower done. And blood work done. Then you still get cross contaminated. I just need help fixing that. Cause I have a 8 year old. And he is constantly getting my things. Didn’t know there was gluten in that much stuff. What do y’all do to help with cross contamination. And bloating 

    I lost my GB too before my celiac disease diagnosis.  But my Celiac disease is in remission thanks to a clean gluten free diet.  I made my house gluten free.  My kid got her gluten fix at school, friends, house, etc.  she has been test d for celiac disease twice.  She thrived on a semi-gluten free diet.  It was not costly, we just ate more naturally gluten free foods more often rather than the costlier gluten-free breads, cakes and cookies.  

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    9 minutes ago, Wheatwacked said:

    This is an excellent article. To Amanda: According to NIH, there are many essential vitamins/minerals that Celiacs don't absorb. Try a nutritarian diet. 

    If a person’s celiac disease is active, they should focus on a strict gluten free diet first.  No sense taking additional vitamins and minerals, if you are not going to address the root cause which would be active celiac disease.  

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    On 11/12/2019 at 10:54 PM, cyclinglady said:

    focus on a strict gluten free diet

    Absolutely, establishing a gluten free diet is first and foremost. It is essential. Celiac Disease is a disease of malabsorption, which I understand to mean that by the time it is diagnosed the person is already deficient in the nutrients the body needs to repair the damage. That's why the list of comorbid symptoms is so vast. The immune system is overworked and does not get enough nutrition to do its job right so other symptoms pop up. The NIH reports nutrients known to be high risk for patients with Celiac Disease. If your diet is nutritionally sufficient and after GFD you are improving nothing needed. But if you are at a plateau and not improving, likely a deficiency is to be found by comparing your actual intake to the individual vitamin/mineral daily requirements and supplementing by diet or chemical, as required. Our bodies are amazing and will repair most damage given the tools and supplies to do the job. If you give a roofer only half of the nails required and short a few sheets of plywood, he'll do his best. The roof will still leak. Minerals and vitamins are the nails and plywood of our bodies.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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