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Complications Of Untreated Celiac Disease

Why People With Celiac Disease Should Not Eat Gluten

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Updated May 21, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

The National Institutes of Health warns of the following complications of celiac disease in patients who do not follow the gluten-free diet. These problems can usually be blamed for the symptoms of celiac disease that are present when the patient is first diagnosed. In many cases, these complications can improve or go away completely if a gluten-free diet is strictly followed.

1. Malnutrition
Even when patients are eating lots of healthy foods, they can become malnourished because the nutrients in the food are not being absorbed. Instead, the vitamins and nutrients are excreted in the stool. Malnutrition in untreated celiacs can cause weight loss, anemia, and vitamin deficiencies that may result in fatigue, stunted growth, neurologicial problems, and low bone density.

2. Decreased Calcium Levels and Osteoporosis
Calcium and vitamin D are lost in the stool instead of being absorbed into the body, leading to rickets in children, a type of kidney stone called an oxalate stone, as well as osteomalacia (softening of the bones), osteopenia, and osteoporosis. Interestingly, bone diseases can occur in people with milder forms of celiac disease who do not appear to have malabsorption. Bone density can actually improve once the gluten-free diet is started.

3. Lactose Intolerance
The enzyme lactase, which helps us digest the lactose in dairy products, is produced in the cells that line the surface of the villi in the small intestine. When the villi shrink and flatten in celiac patients who are eating gluten, lactase can no longer be produced and the patient develops lactose intolerance. Many celiac patients on the gluten-free diet find that once their intestines have healed, lactase production resumes, and they are able to tolerate lactose-containing products.

4. Cancer
According to most studies, long-standing untreated celiac disease leads to an increased risk of gastrointestinal cancer, such as lymphoma. Even with this increased risk, however, these cancers are rare in celiac patients. Some evidence suggests that in celiac patients who follow a strict gluten-free diet, the risk is no greater than in any other healthy person.

5. Neurological and Psychiatric Complications
Celiac disease has also been associated with depression, schizophrenia, anxiety, neuropathy, balance disorders, seizures, and severe headaches.

6. Miscarriage and Congenital Malformation of an Unborn Baby
Pregnant women who don't realize they have celiac disease (or who know they have it but don't follow a gluten-free diet) have nutrient absorption problems that can lead to miscarriage or congenital malformations, such as neural tube defects.

7. Short Stature
In children, undiagnosed celiac disease can lead to short stature. During childhood, it's crucial that children get the right nutrition to help them grow and develop. If they have unrecognized celiac disease and are eating gluten, the damage to their intestines will prevent nutrients in their food from being absorbed. Fortunately, if celiac disease is diagnosed in time, a gluten-free diet can sometimes help a child catch-up to a normal height.

Sources:

The National Institutes of Health.

Ojetti V, Gabrielli M, Migneco A, Lauritano C, Zocco MA, Scarpellini E, Nista EC, Gasbarrini G, Gasbarrini A. Regression of lactose malabsorption in coeliac patients after receiving a gluten-free diet. Scandinavian Journal of Gastroenterology 2007; 5 :1-4.

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