Untreated, celiac disease can cause:
- Malnutrition. The damage to your small intestine means it can't absorb enough nutrients. Malnutrition can lead to anemia and weight loss. In children, malnutrition can cause stunted growth and delayed development.
- Loss of calcium and bone density. Malabsorption of calcium and vitamin D may lead to a softening of the bone (osteomalacia or rickets) in children and a loss of bone density (osteoporosis) in adults.
- Infertility and miscarriage. Malabsorption of calcium and vitamin D can contribute to reproductive issues.
- Lactose intolerance. Damage to your small intestine may cause you to experience abdominal pain and diarrhea after eating lactose-containing dairy products, even though they don't contain gluten. Once your intestine has healed, you may be able to tolerate dairy products again. However, some people continue to experience lactose intolerance despite successful management of celiac disease.
- Cancer. People with celiac disease who don't maintain a gluten-free diet have a greater risk of developing several forms of cancer, including intestinal lymphoma and small bowel cancer.
Nonresponsive celiac disease
As many as 15 percent of people with celiac disease may not have or be able to maintain a good response to the gluten-free diet. This condition, known as nonresponsive celiac disease, is often due to contamination of the diet with gluten.
A Mayo Clinic study found that people with nonresponsive celiac disease often have additional conditions, such as bacteria in the small intestine (bacterial overgrowth), colitis, poor pancreas function or irritable bowel syndrome.
Refractory celiac disease
In rare instances, the intestinal injury of celiac disease continues even though you follow a strict gluten-free diet. This is known as refractory celiac disease.
If you continue to experience signs and symptoms despite following a gluten-free diet for six months to one year, your doctor may recommend further testing to monitor the celiac disease and look for other explanations for your symptoms. Your doctor may recommend treatment with a steroid to reduce intestinal inflammation, or a medication that suppresses your immune system.
May. 22, 2013
- Ludvigsson JF, et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013;62:43.
- AskMayoExpert. What are the most common manifestations of celiac disease today? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Celiac disease. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/indigestion/index.aspx. Accessed March 20, 2013.
- Scanlon SA, et al. Update on celiac disease — etiology, differential diagnosis, drug targets, and management advances. Clinical and Experimental Gastroenterology. 2011;4:297.
- Rashtak S, et al. Review article: Coeliac disease, new approaches to therapy. Alimentary Pharmacology & Therapeutics. 2012;35:768.
- Rubio-Tapia A, et al. The prevalence of celiac disease in the United States. American Journal of Gastroenterology. 2012;107:1538.
- Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed March 21, 2013.
- Rubio-Tapia, A, et al. Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease. Journal of Clinical Gastroenterology. 2009;43:157.
- Rubio-Tapia A, et al. Classification and management of refractory coeliac disease. Gut. 2010;59:547. Accessed March 29, 2013.
- Walker MM, et al. An update in the diagnosis of coeliac disease. Histopathology. 2011;59:166.
- Rubio-Tapia A, et al. Increased prevalence and mortality in undiagnosed celiac disease. Gastroenterology. 2009;137:88.
- Presutti, RJ. Celiac disease. American Family Physician. 2007;76:1795.
You Are ... The Campaign for Mayo Clinic
Mayo Clinic is a not-for-profit organization. Make a difference today.