What Is Silent Celiac Disease?

Silent celiac disease is when a person's body attacks their small intestine as a reaction to the gluten protein in grains like wheat, barley, and rye. However, their reaction doesn't cause common digestive symptoms like diarrhea, constipation, and abdominal pain.

They may have other symptoms of celiac disease, including fatigue and neurological changes. Some people have no symptoms and are said to have "silent celiac disease" or "asymptomatic celiac disease."

This article goes over what silent celiac disease is and why it can still lead to severe intestinal injury. It also explains how the condition is diagnosed and why a gluten-free diet is a necessary treatment.

An illustration with information about how silent (asymptomatic) celiac disease re

Illustration by Laura Porter for Verywell Health

How Silent Celiac Is Revealed

People living with celiac disease are being diagnosed more often thanks to increased awareness and screening—not necessarily because they had symptoms. When someone in your family is diagnosed with celiac, healthcare providers will likely recommend screening for all their close relatives. This screening can pick up cases of celiac disease in people who don't have any symptoms.

Other people are diagnosed with celiac disease because they have a related condition, such as thyroid disease or anemia, and their providers refer them for celiac screening.

For many people, the diagnosis comes as a surprise. If you don't have GI symptoms, you might be shocked to learn you have a serious health condition affecting your digestive tract.

Undiagnosed Celiac Disease

While research suggests that about one in every 100 people has celiac, only around 30% have been diagnosed.

Even when silent celiac disease does not cause symptoms, damage to the finger-like lining of the intestines (villous atrophy) can still happen. Eventually, the intestines become seriously injured.

Challenges of a Gluten-Free Diet

Silent celiac disease offers no clues to suggest you should adopt a gluten-free diet. Even some people living with celiac find it hard to stay on a gluten-free diet when they are not having symptoms and do not notice any obvious problems from eating gluten.

However, there are important reasons to be gluten-free if you have celiac even if you don't have symptoms.

Gluten-Free Diets and Long-Term Health

Following a gluten-free diet may help to prevent some significant health issues related to the condition, such as:

Celiac disease also may play a role in the development of certain cancers.

Celiac Disease and Autoimmune Disorders

People with celiac disease (with or without symptoms), commonly have other autoimmune diseases, such as rheumatoid arthritis and psoriasis. Consuming gluten may make these conditions more likely to develop.

While there has been little research, some studies have suggested that a gluten-free diet could prevent or help to treat these conditions.

What If I Only Have Gluten Once in a While?

If you have celiac, consuming gluten even once or twice a month doesn't give your intestines a chance to heal and may keep the abnormal immune response from the disease going. In this case, eating gluten is "wiping out" the benefits of being gluten-free.

Benefits of a Gluten-Free Diet

A silent celiac disease diagnosis means your health will probably improve when you're following a strict gluten-free diet. People who dismissed mild symptoms as "normal" at first often make the connection between certain symptoms and their diet once they go gluten-free and start feeling better.

Studies have suggested there might also be benefits for people who have not been diagnosed with celiac disease. For example, a gluten-free diet may relieve symptoms and improve health for people living with:

Some research has suggested that people diagnosed with certain types of irritable bowel syndrome (IBS) also may benefit from a gluten-free diet, but more studies are needed.

Summary

Silent celiac disease occurs when people do not have the typical digestive symptoms of the condition when they consume gluten. While a person may not have symptoms (or even an official diagnosis) of celiac, the damage to the intestines from the disease is still taking place.

Following a strict gluten-free diet can be a life-changing decision for people with celiac, but it's the recommended treatment. A gluten-free diet may also help prevent certain related disorders, like inflammatory arthritis.

A Word From Verywell

Silent celiac disease is also sometimes referred to as asymptomatic celiac disease due to a lack of typical symptoms, such as diarrhea, constipation, stomach pain, or other digestive issues. However, it’s important to note that silent celiac disease is still celiac disease, and you will still benefit from a gluten-free diet even if you have mild or no symptoms. It’s worth having a discussion with your healthcare provider if you suspect you might have silent celiac disease.

12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Celiac Disease Foundation. Classical, Non-classical, and Silent Celiac Disease.

  2. Parzanese I, Qehajaj D, Patrinicola F, et al. Celiac disease: from pathophysiology to treatment. World J Gastrointest Pathophysiol. 2017;8(2):27-38. doi:10.4291/wjgp.v8.i2.27

  3. National Institute of Diabetes and Digestive and Kidney Diseases. Eating, Diet and Nutrition for Celiac Disease.

  4. Popp A, Kivelä L, Fuchs V, Kurppa K. Diagnosing celiac disease: towards wide-scale screening and serology-based criteria?. Gastroenterol Res Pract. 2019. doi:10.1155/2019/2916024

  5. Celiac Disease Foundation. What is celiac disease?.

  6. Bommu VJL, Mirza L. Osteoporosis Can Be the Sole Presentation in Celiac DiseaseCureus. 2021;13(12):e20602. doi:10.7759/cureus.20602

  7. Freeman HJ. Celiac-associated pancreatic disease. Ann Gastroenterol. 2016;29(3):241-2. doi:10.20524/aog.2016.0048

  8. Arthritis Foundation. The Connection Between Gluten and Arthritis.

  9. Bruzzese V, Scolieri P, Pepe J. Efficacy of gluten-free diet in patients with rheumatoid arthritisReumatismo. 2021;72(4):213-217. Published 2021 Jan 18. doi:10.4081/reumatismo.2020.1296

  10. Bhatia BK, Millsop JW, Debbaneh M, et al. Diet and psoriasis, part II: celiac disease and role of a gluten-free dietJ Am Acad Dermatol. 2014;71(2):350-358. doi:10.1016/j.jaad.2014.03.017

  11. Niland B, Cash BD. Health benefits and adverse effects of a gluten-free diet in non-celiac disease patients. Gastroenterol Hepatol (N Y). 2018 Feb;14(2):82-91. PMID:29606920

  12. Gentry J, Sherwood L, Haynes J. Gluten-free diet for irritable bowel syndromeafp. 2017;96(1):52-52.

By Jane Anderson
Jane Anderson is a medical journalist and an expert in celiac disease, gluten sensitivity, and the gluten-free diet.