Celiac disease is a chronic bowel disease, triggered by the consumption of gluten, a mixture of proteins contained in some cereals (wheat, barley, rye, etc.). The disease is mainly manifested by digestive symptoms (diarrhea, pain, bloating, etc.). (1)
In people with celiac disease, gluten intake causes an abnormal immune response in the small intestine, which causes inflammation and damages the intestinal wall. More specifically, it is the intestinal villi that are destroyed. These are small wave-shaped structures that make up the inner folds of the intestine and allow the absorption of nutrients, vitamins, and minerals.
If the inflammation persists, the damaged intestine becomes unable to absorb certain nutrients, vitamins, and minerals. This can lead to malnutrition despite normal and adequate intake nutrition through diet.
Other symptoms of varying intensity may occur, such as fatigue, depression and joint pain. Over time, more serious health problems may appear if it is kept untreated. Affected individuals can, however, get back to a healthy life by eliminating gluten from their diet. (1) (2)
How Dangerous Is Celiac Disease?
Celiac disease is dangerous if it remains undiagnosed for long and no treatment is initiated even after diagnosis. Late-onset of treatment may cause permanent damage to the intestinal villi causing malnutrition and related symptoms (even early death). But these situations are rare as a gluten-free diet after diagnosis can reverse the condition over time and the patient can lead a healthy life. The only thing is to continue maintaining a gluten-free diet for life. (3)
Is Celiac Disease Contagious?
It is a hereditary autoimmune disease, meaning it can be transferred to the offspring from the parents. When a close family member is affected, the probability of being affected is about 20%. But it is not an infection (from other organisms) and thus cannot be contagious (pass from one individual to another by any means).
Although the term “gluten intolerance” is often used along with celiac disease, they are different in the sense that celiac disease is not really food intolerance and an immune reaction is involved.
The abnormal reaction of the immune system also turns against the body by attacking the lining of the small intestine. Celiac disease is an autoimmune disease induced by the ingestion of gluten.
Gluten sensitivity which is not related to celiac disease manifests itself in symptoms similar to those of celiac disease and irritable bowel syndrome when consuming foods containing gluten. Prevalence of 3-6% of the population is estimated but poorly defined due to the frequency of self-diagnosis without medical advice. (4)
Gluten is an elastic and viscous protein mass which present in the grains of several kinds of cereal, including wheat, barley, and rye. Thus, gluten is found in many foods (bread, biscuits, pasta, etc.). It offers a smooth texture to bread and other baked goods, gluten allows ingredients to bond well together and is often used in sauces and prepared dishes. In wheat, the immune reaction is directed against gliadin (a protein fraction present in wheat gluten). It is hordein for barley secalin for rye.
There are other elements that come into play and not yet been precisely identified. It seems that environmental factors (intestinal infections, trauma, the stress generated by surgery or pregnancy) can sometimes be responsible for triggering the disease. There may be greater intestinal permeability in people predisposed to this disease. This would allow some of the gluten to enter the lining of the small intestine, triggering an immune response. (5)
Possible Complications Of Celiac Disease
Celiac disease can have several health consequences if left untreated (not adopting a gluten-free diet). The most common complications are related to the poor absorption of nutrients in the intestine. Common complications of celiac disease are:
Malnutrition – Due to the malabsorption of nutrients in the intestine, malnutrition may take place causing fatigue, weight loss, muscle weakness, and other deficiencies.
Lactose Intolerance – Due to damage to the intestinal wall, lactose intolerance may occur. Usually, it disappears sometime after adopting a gluten-free diet.
Anemia – Due to the poor absorption of iron, the body’s iron stores are depleted, causing anemia.
Osteoporosis – The poor absorption of calcium and vitamin D results in a loss of bone density that can lead to osteoporosis.
Kidney Stones – There is a relatively low risk of kidney stones that are caused by abnormal absorption of oxalates.
Other complications may also occur (neuropathy, infertility, arthritis, herpetiform dermatitis, some type of cancers), which are not always related to intestinal absorption of nutrients. They are still poorly understood. (6)
- Green PH, Lebwohl B, Greywoode R. Celiac disease. Journal of Allergy and Clinical Immunology. 2015;135(5):1099-1106.
- Lebwohl B, Ludvigsson JF, Green PH. Celiac disease and non-celiac gluten sensitivity. Bmj. 2015;351:h4347.
- Çaltepe G. The hidden danger: Silent celiac disease. The Turkish Journal of Gastroenterology. 2018;29(5):530.
- Leonard MM, Sapone A, Catassi C, Fasano A. Celiac disease and nonceliac gluten sensitivity: a review. Jama. 2017;318(7):647-656.
- Biesiekierski JR. What is gluten? Journal of gastroenterology and hepatology. 2017;32:78-81.
- Biagi F, Schiepatti A, Maiorano G, et al. Risk of complications in coeliac patients depends on age at diagnosis and type of clinical presentation. Digestive and Liver Disease. 2018;50(6):549-552.
- Celiac Disease: Causes, Risk Factors, Signs, Symptoms, Investigations, Treatment
- Difference Between Celiac Disease & Gluten Intolerance
- Can Celiac Disease Go Away On Its Own & What Are It’s Natural Remedies?
- Lifestyle Changes For Celiac Disease
- Who Is At Risk For Celiac Disease & Is There A Blood Test For It?