

Celiac disease is considered an autoimmune condition that affects the digestive system. Its symptoms can sometimes begin in childhood and continue throughout adulthood and even into old age. Although some people may think it's a minor illness, it can become a serious health risk if not properly diagnosed and treated in time.In this Daleeli Medical article, we’ll explore all the essential information about celiac disease—its symptoms, how it affects our health at different stages of life, and the latest treatment and prevention methods that can help us live a normal, complication-free life.
What Is Celiac Disease?
Celiac disease is a chronic autoimmune condition that affects the digestive system. Simply put, your body mistakenly reacts to a protein called gluten—which is found in wheat, barley, and other grains—with an exaggerated immune response. This immune reaction produces antibodies that attack the lining of the small intestine, which is the area responsible for absorbing essential nutrients from food.
When the lining of the intestine is damaged, your body can no longer absorb vitamins and minerals properly, leading to nutritional deficiencies—even if you're eating well.
When Does Celiac Disease Start?
Celiac disease can develop at any age after introducing gluten into the diet, but it commonly appears during two key periods:
First period: When a baby starts eating solid foods containing gluten, usually between 8 to 12 months of age.
Second period: Between ages 40 and 60, when the disease may suddenly emerge after years of eating gluten without noticeable issues.
Can Celiac Disease Affect Mental Health?
Yes. Chronic inflammation in the body and poor absorption of essential nutrients can affect the brain and nervous system. That’s why many people with celiac disease experience depression or anxiety.
Is Celiac Disease Related to Lactose Intolerance?
Not exactly a true allergy, but due to intestinal damage, some people may temporarily struggle to digest lactose (the sugar in dairy products). This usually improves as the gut heals on a gluten-free diet.
Can Celiac Disease Suddenly Appear After Years of Eating Gluten?
Yes, it absolutely can. Some people eat gluten for years without any symptoms, then suddenly develop signs of the disease later in life.
Can Celiac Disease Cause Constant Fatigue Without a Clear Reason?
Definitely. Damaged intestines absorb fewer nutrients, leaving the body low on energy, which can cause chronic tiredness even when no other explanation is obvious.
Can Celiac Disease Cause Hair Loss?
Yes. Poor absorption of vital nutrients caused by celiac disease can affect hair health, leading to hair thinning or loss.
Can Celiac Disease Cause a Strange Skin Rash?
Absolutely! There’s a skin-related form of celiac disease called Dermatitis Herpetiformis. It appears as itchy bumps or rashes and is considered a clear sign of gluten sensitivity.
Is Celiac Disease Linked to Allergies to Foods Other Than Gluten?
It can be. Inflammation from celiac disease may make the immune system more sensitive, increasing the likelihood of reacting to other foods.
Can Celiac Disease Cause Dental Problems?
Yes. Deficiencies in essential nutrients like calcium and vitamin D can weaken teeth and make them more prone to decay.
Can Celiac Disease Cause Psychological Issues Like Panic Attacks?
It’s possible. Ongoing inflammation and its effect on the nervous system may lead to mental health challenges such as anxiety and panic attacks.
Does Celiac Disease Affect Children Differently Than Adults?
Yes, children with celiac disease may experience:
Delayed growth
Underweight issues
This is due to poor nutrient absorption, which impacts their overall development.
Can Celiac Disease Delay Puberty in Children?
Yes. Nutritional deficiencies caused by the disease can slow down physical development, delaying the normal signs of puberty.
Can Celiac Disease Cause Joint Pain?
Yes, the inflammation triggered by celiac disease can affect more than just the gut—it can also reach other areas like the joints, causing pain and swelling.
Can Someone With Celiac Disease Eat a Small Amount of Gluten Without Harm?
No. Even tiny amounts of gluten can trigger an immune response and damage the intestines. It's essential to strictly avoid gluten to protect your gut health.
Can Celiac Disease Make You Feel Mentally Foggy or Forgetful?
Yes. Many people experience what's known as "brain fog"—difficulty focusing or remembering things—due to chronic inflammation and poor nutrient absorption affecting the brain.
Can Celiac Disease Cause Unusual Body Odor?
Yes, it can. Digestive issues and poor nutrient absorption can affect the body’s natural processes, which may lead to changes in body odor.
Can Celiac Disease Affect Organs Other Than the Intestines, Like the Liver or Lungs?
Celiac disease mainly affects the intestines, but in some cases, the autoimmune inflammation can also impact other organs, such as the liver or lungs.
Can Celiac Disease Change Your Voice or Cause Throat Problems?
It’s not common, but it can happen occasionally due to overall inflammation in the body, which may affect the throat or vocal cords.
Can Celiac Disease Lead to Social Anxiety or Isolation?
Yes, especially when symptoms are chronic and exhausting. This can negatively impact a person’s mental health and quality of life, leading to isolation or social anxiety.
Does Celiac Disease Affect the Sense of Smell or Taste?
It can, in some cases. Deficiencies in vitamins and minerals, along with chronic inflammation, may damage the nerves responsible for smell and taste.
Can Celiac Disease Cause Skin Discoloration or Yellowing?
In rare cases, yes. Celiac disease can cause yellowing or other skin color changes due to nutritional deficiencies or liver-related complications.
Can Celiac Disease Lead to Vision Problems?
Yes. A deficiency in vitamin A caused by poor absorption can lead to eye and vision issues.
Can Celiac Disease Cause Unexplained Bone Pain?
Absolutely. A lack of calcium and vitamin D, combined with chronic inflammation, can lead to bone pain without a clear cause.
Can Celiac Disease Cause Medication Sensitivities?
Yes. People with celiac disease often have a more sensitive immune system, which can increase their risk of drug allergies or reactions.
Is Celiac Disease Contagious or Can It Be Transmitted?
No, celiac disease is not contagious. It’s an autoimmune, genetic condition—meaning it can run in families, but it doesn’t spread through contact.
Are Gluten-Free Foods Healthier for People Without Celiac Disease?
Not necessarily. Gluten-free products can be lower in important nutrients like fiber and vitamins, so they’re not always a healthier option for people who don’t need to avoid gluten.
Is Celiac Disease Associated with Weight Gain or Obesity?
It’s more common for celiac disease to cause weight loss due to poor absorption, but some people may gain weight for various reasons, even with the condition.
Can Celiac Disease Be Completely Cured?
No. Celiac disease is a lifelong condition, but symptoms can be controlled, and complications prevented, by strictly following a gluten-free diet.
Is There Something Called “Silent Celiac Disease”?
Yes. Some people have intestinal damage without obvious symptoms. This form of the disease is often discovered only through medical testing.
Does Celiac Disease Treatment Involve Lifestyle Changes Besides Diet?
A gluten-free diet is the core of treatment, but reducing stress and engaging in regular physical activity can improve symptoms and support overall health.
Can Stress Trigger Celiac Symptoms?
Stress doesn’t cause celiac disease, but it can worsen symptoms or make them more noticeable.
Can Celiac Disease Lead to Other Autoimmune Conditions?
Yes. People with celiac disease are at higher risk of developing other autoimmune disorders like type 1 diabetes or thyroid problems.
Does Celiac Disease Affect Fertility or Pregnancy?
If left untreated, celiac disease can cause fertility issues and pregnancy complications.
Do Children with Celiac Disease Need to Avoid Gluten for Life?
Yes. Since celiac disease is a chronic condition, lifelong adherence to a gluten-free diet is essential.
Are There Any New Medications That Treat Celiac Without a Gluten-Free Diet?
There are ongoing studies exploring new treatments, but currently, there’s no approved medication that replaces the gluten-free diet.
Can Medications or Supplements Containing Gluten Trigger Symptoms?
Yes. They can cause symptoms, so it's important to check that all medications and supplements are gluten-free.
Are There Different Levels of Celiac Disease?
Yes. Celiac disease varies in severity depending on symptoms and intestinal damage. The main types include:
Silent Celiac (Latent/Asymptomatic)
The person has intestinal damage but no clear symptoms.
Active Celiac
Symptoms like diarrhea, weight loss, fatigue, and nutrient deficiencies are present, along with visible damage to the small intestine.
Mild Celiac
Symptoms are less severe, such as mild bloating or fatigue, with minor intestinal changes.
Severe Celiac
Strong and chronic symptoms, significant intestinal damage, and serious nutritional deficiencies are present.
Refractory Celiac
A rare type where symptoms persist even after following a strict gluten-free diet.
Is Celiac Disease Dangerous?
Yes, if left untreated. The small intestine becomes damaged and can’t absorb essential nutrients properly, leading to malnutrition and vitamin/mineral deficiencies. In children, this may cause stunted growth and delayed development.
Genetic Factors
Celiac disease is closely linked to specific genes, especially HLA-DQ2 and HLA-DQ8. These genes are commonly found in both children and adults who develop the disease. Having a close family member with celiac increases the risk significantly.
Gluten Sensitivity
Gluten is a protein found in wheat, barley, and rye. In individuals with celiac disease, consuming gluten triggers an immune response that mistakenly attacks the lining of the small intestine, leading to inflammation and damage.
Environmental Factors
Nutrition (in children): Introducing gluten before 4 months or after 7 months of age may increase the risk.
Dietary changes (in adults): Sudden changes in diet or unexpected exposure to gluten can trigger the onset of symptoms.
Viral infections: Viruses like rotavirus or Epstein-Barr virus may activate the disease in genetically susceptible individuals.
Stress and surgeries: Emotional stress or major surgical procedures may trigger the disease in some cases.
Presence of Other Autoimmune Disorders
Individuals with autoimmune diseases like:
Type 1 diabetes
Autoimmune thyroiditis
are at a higher risk of developing celiac disease, both in childhood and adulthood.
Symptoms often appear soon after consuming gluten and mainly affect the digestive system:
Abdominal pain
Bloating or a feeling of fullness
Constipation or diarrhea
Excessive gas
Heartburn
Nausea
Pale or foul-smelling stools
Over time, due to poor nutrient absorption, other symptoms may develop:
Anemia
Bone or joint pain
Itchy skin rash (dermatitis herpetiformis)
Chronic headaches
General fatigue and weak bones
Mood changes or depression
Mouth ulcers and dental issues
Nervous system problems like numbness or tingling in hands and feet, and balance issues
Poor spleen function
Unexplained weight loss
Celiac disease can affect women's reproductive health and cause:
Irregular menstrual cycles
Early menopause
Pregnancy complications, such as miscarriage
Untreated celiac has been linked to infertility in both men and women
Digestive symptoms are usually more noticeable in kids:
Bloated or swollen belly
Constipation or diarrhea
Pale, foul-smelling stools
Stomach upset or vomiting
Unexplained weight loss
Diagnosing celiac disease involves several key tests and evaluations:
Blood Tests
The first and most important step in diagnosis includes:
tTG-IgA (Tissue Transglutaminase Antibodies)
The most common and accurate test. It detects immune reactions to gluten.
EMA (Endomysial Antibodies)
Highly specific and often used to confirm diagnosis after a positive tTG test, though it's more expensive.
Total IgA Test
Important to rule out IgA deficiency, which could lead to false-negative results in the antibody tests.
Other tests (less commonly used):
Such as antigliadin antibodies, though they are less accurate and rarely used now.
If blood test results are positive or inconclusive, the doctor may recommend an upper endoscopy.
During the procedure, a small sample (biopsy) is taken from the lining of the small intestine.
This sample is examined under a microscope to check for damage to the intestinal villi, which is a key sign of celiac disease.
In some cases, the doctor may request genetic testing for HLA-DQ2 and HLA-DQ8 genes.
If these genes are not present, the likelihood of having celiac disease is very low.
If they are present, it doesn't necessarily mean you have the disease, since many people carry these genes without developing symptoms.
Diagnosing celiac disease involves a combination of steps and tests to confirm the condition accurately. Here’s how the process works:
Delayed growth
Unexplained weight loss
Chronic or persistent diarrhea
Abdominal bloating and swelling
Recurrent stomach cramps
Fatigue and general weakness
Sometimes, a distinctive skin rash called dermatitis herpetiformis
Diarrhea or constipation
Abdominal bloating and pain
Ongoing fatigue and deficiencies in vitamins and minerals
Osteoporosis
Sometimes, non-digestive symptoms like mood changes or bone pain
Anti-tTG IgA (Tissue Transglutaminase Antibodies):
The most accurate and widely used test to detect celiac disease.
EMA (Endomysial Antibodies):
Very sensitive and used to confirm diagnosis. Less commonly used due to higher cost.
Total IgA Level:
Ensures there's no IgA deficiency that could affect test results.
Other Tests (less common):
Such as antigliadin antibodies – less accurate and rarely used today.
Checks for the presence of HLA-DQ2 and HLA-DQ8 genes:
If absent → extremely low risk of having celiac.
If present → increases risk but does not confirm the disease alone.
If blood tests are unclear or positive, an upper endoscopy is performed:
A small sample (biopsy) is taken from the small intestine.
The sample is examined to detect villi damage, which is a hallmark of celiac disease.
Biopsy is especially important in unclear cases and helps assess the severity of damage.
In some situations, the doctor may start a gluten-free diet and observe symptom improvement.
If the patient improves, it's a strong indication of celiac disease.
This method is often used alongside other diagnostic tools.
If celiac disease is left undiagnosed or untreated, it can lead to serious health problems. These complications can vary by age group.
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1. Delayed growth:
Due to poor absorption of nutrients, children with celiac disease may have delayed height and weight gain compared to their peers.
2. Vitamin and mineral deficiencies:
Iron deficiency can lead to anemia, and a lack of vitamin D and calcium can weaken the bones, causing conditions like rickets or osteoporosis.
3. Digestive issues:
Such as chronic diarrhea, bloated belly, abdominal cramps, and sometimes constipation.
4. Delayed puberty:
Poor growth and malnutrition can affect growth hormones and delay puberty.
5. Psychological and behavioral issues:
Children may experience irritability, anxiety, and trouble concentrating.
6. Dental problems:
Changes in tooth enamel and white spots may occur due to nutritional deficiencies.
1. Malnutrition:
Poor absorption of vital nutrients like iron, vitamin B12, and folic acid may cause anemia and chronic fatigue.
2. Osteoporosis:
Calcium and vitamin D deficiency leads to weakened bones and increases fracture risk.
3. Digestive problems:
Symptoms include diarrhea, constipation, bloating, and chronic abdominal pain.
4. Chronic fatigue:
Ongoing inflammation and nutrient deficiencies contribute to persistent tiredness.
5. Autoimmune complications:
Higher risk of developing other autoimmune diseases like type 1 diabetes, thyroid disorders, or liver diseases.
6. Increased cancer risk:
Untreated celiac disease may raise the risk of intestinal cancer and certain lymphomas.
7. Skin conditions:
A specific itchy rash called dermatitis herpetiformis may appear in some cases.
1. Follow a strict gluten-free diet:
Gluten triggers intestinal damage, so avoid all foods containing wheat, barley, rye, and certain oats (unless labeled gluten-free).
Always check food labels.
Stick to safe, natural foods like rice, potatoes, vegetables, fruits, and unprocessed meats.
2. Watch out for cross-contamination:
Even gluten-free food can get contaminated through kitchen tools or surfaces.
Use separate utensils and cookware.
Keep the fridge and cooking areas clean.
3. Regular check-ups with a specialist:
Gastroenterologist follow-ups are essential to:
Monitor intestinal healing.
Check vitamin and mineral levels regularly.
4. Take supplements when needed:
If deficiencies are found (iron, vitamin D, calcium), your doctor may recommend supplements to restore balance.
5. Prioritize rest and quality sleep:
Since fatigue is common, a regular, restful sleep routine helps the body recover and cope better.
6. Manage stress effectively:
Stress can worsen symptoms. Try relaxation techniques like deep breathing, yoga, or nature walks.
7. Educate family and school (for children):
Teach the child, family members, and school staff about the importance of a gluten-free diet to prevent accidental gluten exposure and ensure better symptom control.
8. Monitor for new or returning symptoms:
If any new symptoms appear or old ones come back, consult the doctor immediately for evaluation and treatment.
Chronic intestinal damage: The intestines lose their ability to absorb nutrients, leading to severe malnutrition.
Delayed growth and development: The child may fall behind in physical and mental development.
Nutrient deficiencies: Iron, calcium, and vitamin D deficiencies affect bone health and teeth.
Chronic digestive symptoms: Like persistent diarrhea, bloating, and cramps.
Weakened immunity: Making the child more prone to illnesses and infections.
Emotional issues: Ongoing symptoms may cause stress and anxiety, affecting the child’s well-being.
Chronic intestinal damage: Leads to poor nutrient absorption and general malnutrition.
Anemia and osteoporosis: Due to deficiencies in iron, calcium, and vitamin D, raising the risk of fractures.
Higher risk of autoimmune diseases: Such as thyroid disorders and type 1 diabetes.
For example, intestinal lymphoma. Although it's rare, it's a serious and dangerous complication.
Such as severe fatigue, abdominal pain, and ongoing digestive issues.
Including depression and anxiety due to the constant health challenges.
Wheat and all its products: bread, pasta, cake, biscuits.
Barley.
Rye.
Triticale (a hybrid of wheat and rye).
Certain sauces, like regular soy sauce.
Ready-made soups and canned broth.
Processed meats like salami, sausages, and hot dogs that may contain gluten additives.
Frozen foods like pre-made pies and pizzas.
White and whole wheat bread.
Cakes, biscuits, and pastries.
Some types of beer and ale made from barley.
Some dietary supplements and vitamins.
Flavored foods or sauces with gluten-based additives (sometimes found in spice blends or marinades).
To help improve the condition and relieve symptoms, focus on healthy gluten-free foods such as:
Rice.
Corn.
Quinoa (a nutritious, high-protein grain).
Potatoes.
Lentils and beans (great plant-based protein sources).
Gluten-free oats (always check the label).
All fresh or cooked vegetables, rich in fiber and essential vitamins.
Fresh fruits like apples, bananas, oranges, berries, and mangoes.
Fiber-rich foods support better digestion and gut health.
Fresh meats such as chicken, beef, or fish without sauces or seasonings that may contain gluten.
Eggs.
Legumes like lentils, chickpeas, and beans.
Milk, cheese, and plain yogurt.
Choose dairy products without additives that may contain gluten.
Almonds, walnuts, sunflower seeds, and chia seeds – all are nutritious and beneficial.
Olive oil.
Coconut oil.
Avocado oil.
Completely avoid wheat, barley, rye, and triticale.
Following this diet helps your intestinal lining heal and improves digestion.
Use safe alternatives like rice, corn, potatoes, quinoa, and certified gluten-free oats.
Get regular blood tests to monitor vitamin and mineral levels.
In some cases, your doctor may recommend an endoscopy to check how well the intestines are healing.
Monitor your symptoms and make sure you’re not accidentally consuming gluten.
To compensate for deficiencies in iron, calcium, vitamin D, and vitamin B12.
Iron supplements are especially important if you're dealing with anemia due to poor absorption.
It's crucial to understand which foods are safe and which aren't.
Be aware of hidden gluten in sauces, spices, or packaged foods.
Always read food labels before buying any packaged product.
If you have diarrhea, cramps, or other complications, they should be managed under a doctor’s care.
Celiac disease is usually managed by a gastroenterologist — a doctor who specializes in digestive system disorders, including intestinal inflammation, malabsorption, and conditions like celiac disease.
You may also need:
A nutritionist to help you create a balanced, gluten-free diet.
A pediatrician if the patient is a child.
A family doctor (general practitioner) for overall health monitoring and coordination of care.