Typical presentation in adults

Coeliac disease is asymptomatic in up to 60% of adults. In the remainder, typical features, with the incidence in parentheses, include:

General effects (80%):

• malaise
• weakness
• weight loss

Gastrointestinal:

• diarrhoea and steatorrhoea (80%)
• abdominal distension and pain (30%)
• nausea and vomiting (30%)
• oral apthous ulcers (5-10%)

Metabolic effects:

• combined iron and folate deficiency (85%)
• vitamin K deficiency (10%)
• vitamin D deficiency and hypocalcaemia (15-30%)

Miscellaneous:

• skin rashes - including dermatitis herpetiformis
• peripheral neuropathy
• psychological disturbance
• peripheral oedema
• cerebrospinal degenerations
• reduced fertility
• relapse in pregnancy or puerperium