celiac disease complications

What are Complications of Celiac Disease?

Celiac disease is a serious condition affecting the digestive tract and other organs. The exact number of celiac disease cases is unknown. Based on serologic studies, the prevalence is 1.4%; based on bowel biopsies it’s 0.7%. The real numbers are likely higher as the condition is often undiagnosed.

Females are more affected by the disease than males. Children are more likely to have the condition compared to adults. The prevalence also varies by location.

If you or your child shows symptoms of celiac disease, it’s a good idea to talk to your doctor. The sooner you get diagnosed and start treatment you can better prevent serious complications.

Some studies suggest celiac disease affects life expectancy and may be associated with a twofold increase in mortality. However, we need more research on this.

In this article, we’ll discuss celiac disease complications and how to prevent them.

Micro and Macro-Nutrient Deficiencies

Nutrient deficiencies, sometimes multiple or severe, cause most of the complications. Celiac disease causes damage to the small bowel. So, when someone ingests gluten, it isn’t able to absorb vitamins and minerals.

Untreated celiac disease is often associated with low levels of minerals. The following deficiencies are common:

  • Iron
  • Calcium
  • Zinc
  • Magnesium
  • Folate (B9)
  • Cobalmin (B12)
  • Ribflavin (B2)
  • Niacin (B3)
  • Vitamin D

The disease also affects your macronutrients. It leads to malabsorption, malnutrition, and failure to thrive in children.

The body does not properly absorb fats, so it eliminates them in the stools. Those with celiac disease also have fiber and protein deficiencies. Lactose intolerance is also a potential celiac disease complication.

celiac disease complications - doctors examining x-ray

Complications Affecting the Bones

Low calcium, Vitamin D, and magnesium levels play a key role in the development of bone diseases. These deficiencies could cause the bones to become brittle. People with untreated celiac disease have a higher risk of developing osteopenia, osteomalacia, and osteoporosis.

Impaired mineralization, often due to severe Vitamin D deficiency causes osteomalacia. Osteopenia causes a lower bone density than normal but is not severe enough to cause osteoporosis. Osteoporosis is the result of low peak bone mass, increased bone resorption, and impaired bone formation.

Weak bones lead to increased risk for fractures and limitations on physical activities.

celiac disease complications - blood vials labeled anemia

Complications Leading to Anemia

Iron deficiency anemia is the most common form of anemia diagnosed with celiac. Deficiencies in Vitamins B12 and B9 (folate) can also cause anemia that persists for months even after having a gluten-free diet.

Symptoms of anemia include:

  • Extreme fatigue
  • Weakness
  • Pale skin
  • Shortness of breath
  • Dizziness
  • Sleeping problems
  • Numbness
  • Tingling
  • Unusual heartbeats

Researchers have also linked severe B12 deficiency to dementia.

celiac disease complications - pregnant woman holding positive test

Complications Affecting Fertility

Studies have linked infertility with untreated celiac disease cases. Some studies show celiac disease can cause pregnancy complications, spontaneous abortion, and premature birth.
Researchers believe those with fertility issues may have subclinical celiac disease. Cases of unexplained infertility may be due to silent celiac disease. Multiple nutrient deficiencies and abnormal immune responses may be the cause of these issues.

celiac disease complications - woman holding her side in pain

Complications Affecting the Liver and Digestive Tract

The main complication of celiac disease affecting the gut is microscopic colitis. This is inflammation of the small bowel and shows under a microscope. There is also damage to the lining of the small intestine.

Other organs affected include the gallbladder and pancreas. The liver can also become damaged. Celiac disease can cause liver cirrhosis, hepatitis, and liver cancer.

celiac disease complications - green ribbon for lymphoma

Autoimmune Diseases and Cancers Associated with Celiac Disease

Celiac disease is an autoimmune disease in itself. If untreated, it can increase the risk of other autoimmune diseases like type 1 diabetes and thyroid conditions. Those with celiac and autoimmune diseases are also more likely to have dermatitis herpetiformis, a skin rash.

This condition also raises the risk of various cancers affecting the upper digestive tract, as well as liver cancer and lymphoma. Doctors diagnose lymphoma in one out of 1,000 individuals with celiac disease.

celiac disease complications - doctor and patient holding red cartoon heart

Complications Affecting the Heart and Nervous System

If left untreated, celiac disease can cause cardiovascular complications. These include coronary heart diseases, enlarged heart (dilated cardiomyopathy), arterial fibrillation, and venous thrombosis.

Peripheral neuropathy and problems with controlling their movement (ataxia) are possible complications. Anxiety and depression are also more common in those with celiac disease than in the general population.

Preventing Celiac Disease Complications

One simple solution to prevent celiac disease complications is a gluten-free diet. The diet protects from complications like infertility, osteoporosis, and cancer. A gluten-free diet also improves nutrient absorption and maintains a healthy lining of the small bowel. If you try this diet, make sure to take supplements as well.