A Case of Anxiety Alleviated by Diet: The Overlooked Connection in Celiac Disease

Background: Celiac disease is a prevalent autoimmune disorder characterized by an immune response to gluten, resulting in malabsorption and a wide range of gastrointestinal (GI) and extra-intestinal symptoms. While classic GI symptoms such as diarrhea, bloating, and steatorrhea are common, variations in symptomatology exist, with some patients presenting with atypical symptoms such as dyspepsia or constipation. In adults, celiac disease often manifests with behavioral disturbances like anxiety and aggression, complicating diagnosis.Case Report: A 27-year-old female with a history of generalized anxiety disorder presented with diarrhea, bloating, weight loss, and increasing abdominal distension. Her symptoms, including behavioral changes such as escalating aggression and overeating, were initially attributed to psychiatric issues. Laboratory findings revealed anemia, multiple vitamin deficiencies, and elevated tissue transglutaminase IgA antibodies, leading to a diagnosis of celiac disease confirmed through esophagogastroduodenoscopy (EGD) and histological examination. The patient condition showed substantial improvement after a gluten-free diet initiation.Conclusion: Celiac disease can present predominantly psychiatric symptoms, leading to diagnostic challenges and delayed treatment. Early recognition and gluten-free diet initiation can result in significant symptom improvement. Clinicians should consider celiac disease in patients with psychiatric symptoms, especially when GI complaints are present, to facilitate timely diagnosis and intervention.