banner image

Reading Time: 6 minutes 7s

Celiac Disease

Celiac disease is an autoimmune disorder that results from an immune reaction to consuming gluten, a protein present in barley, wheat, and rye. Upon eating gluten, people with this problem usually experience an immune response in the small intestine. As the disease progresses with time, the reaction causes damage to the lining of the small intestine, preventing nutrient absorption (a condition known as malabsorption).

The damage typically triggers symptoms like diarrhea, weight loss, fatigue, bloating, and anemia, with potentially severe complications if left untreated. Apart from gastrointestinal signs, malabsorption in children can also have an impact on their overall growth and development.

Currently, there is no definitive cure for celiac disease. However, adhering to a strict gluten-free diet can aid in symptom management and facilitate intestinal healing.

By Able Health I Medically reviewed by Dr. Alireza Estedlal

Page last reviewed: February 2024 I Next review due: February 2026

What is celiac disease?

Celiac disease (coeliac disease) is an autoimmune condition in which the immune system in the body responds to gluten abnormally. Gluten is a protein that is normally found in grains like barley, wheat, and rye.

Upon consuming gluten, the immune system of people with celiac disease mistakenly attacks the lining of the small intestine. This reaction causes inflammation and leads to damage of the villi, small finger-like projections bordering the small intestine and facilitating absorption of nutrients.

Types of celiac disease

Celiac disease can manifest in various ways, resulting in different kinds of illness.

Classical celiac disease is the most prevalent type that is characterized by gastrointestinal symptoms like diarrhea and abdominal pain. Atypical types of the condition, on the other hand, can present mild or non-specific symptoms.

Refractory celiac disease is another type of celiac disease. It usually arises when people with the illness continue experiencing the symptoms and intestine lining damage in spite of observing a strict gluten-free diet. This kind of condition is also rare, and effective management might necessitate further medical interventions.

Symptoms of Celiac Disease

The symptoms associated with celiac disease can widely vary and may differ in minors and adults. Adults with digestive problems are likely to experience these symptoms:

  • Diarrhea
  • Weight loss
  • Fatigue
  • Abdominal pain
  • Bloating and gas
  • Constipation
  • Nausea and vomiting

Nonetheless, over 50% of adults with celiac disease experience symptoms unrelated to the digestive system. They include:

  • Anemia, often resulting from iron deficiently caused by reduced absorption of iron.
  • Osteoporosis, bone density loss or osteomalacia, softening of the bones.
  • Dermatitis herpetiformis, which causes itchiness and blistery skin rash.
  • Headaches and fatigues
  • Mouth ulcers
  • Nervous system damage, causing tingling and numbness in hands and feet, cognitive impairment, and possible balancing problems.
  • Joint pain
  • Hyposplenism, reduced spleen function
  • Raised liver enzyme levels

Unlike adults, kids with celiac disease have a higher possibility of experiencing digestive problems such as:

  • Chronic diarrhea
  • Nausea and vomiting
  • Constipation
  • Swollen stomach
  • Gas
  • Pale and foul-smelling stool

In addition, the inability to take up nutrients may lead to:

  • Infants’ failure to thrive
  • Tooth enamel impairment
  • Weight loss
  • Irritability
  • Anemia
  • Short stature
  • Delayed puberty
  • Neurological symptoms such as attention-deficit/hyperactivity disorder (ADHD), learning disabilities, lack of muscle coordination, seizures, and headaches.

Talk to our doctor if you’re concerned about symptoms

You can book an appointment with a private GP today for only £20*.

Book an appointment

Dermatitis herpetiformis

This blistering skin condition can occur due to gluten intolerance. Typically, the rash manifests in areas like the knees, elbows, scalp, buttocks, and torso.

Although dermatitis herpetiformis is usually linked to changes in the small intestine lining, similar to celiac disease, the skin problem may not trigger digestive symptoms. The physician will treat the condition by providing a gluten-free diet or medications or recommend both options to manage the rash.

Causes of Celiac Disease

Although the exact cause of celiac disease remains unknown, factors like genes and consuming foods containing glutens are likely to contribute to the condition. Gastrointestinal infections, infant feeding methods, and gut bacteria are also thought to play a role. However, no conclusive evidence supports these theories. In some cases, celiac disease is triggered following events like pregnancy, childbirth, surgery, viral infections, and acute emotional stress.

Overreaction of the immune system due to gluten food causes damage to the villi, the hair-like projections lining the small intestine. The primary role of villi in the body involves the absorption of nutrients, like minerals and vitamins, from food. Therefore, damage to the villi means you cannot get sufficient nutrients regardless of how much you eat.

Risk Factors of Celiac Disease

Factors that are more likely to increase the risk of developing celiac disease are:

  • Having a blood relative with celiac disease or dermatitis herpetiformis
  • Down syndrome, Turner syndrome, or William syndrome
  • Type 1 diabetes
  • Autoimmune thyroid disease
  • Addison’s disease
  • Microscopic colitis

Complications of celiac disease

Untreated celiac disease could lead to complications such as:

  • Malnutrition: Insufficient nutrient absorption in the small intestine leads to malnutrition, which could eventually result in weight loss and anemia. Malnutrition is likely to cause short stature and slowed growth in children.
  • Weakening of the bones: Malabsorption of vitamin D and calcium may result in osteomalacia or rickets, a bone-softening condition in children. Adults, on the other hand, may develop osteopenia or osteoporosis, bone density loss.
  • Lactose intolerance: Small intestine damage can lead to diarrhea and abdominal pain after consuming dairy products containing lactose. However, healing of the intestine may restore tolerance to dairy products.
  • Reproductive problems: Vitamin D and calcium malabsorption can contribute to infertility and miscarriage.
  • Cancer: Failure to follow a gluten-free diet increases the risks of developing small bowel and lymphoma cancer.
  • Nervous system disorders: For some individuals, celiac disease can contribute to conditions like seizures or peripheral neuropathy, a nerve disease affecting hands and feet.

Celiac Disease Diagnosis

Why is early diagnosis of celiac disease important?

Most individuals with celiac disease are unaware that they actually have it. Nonetheless, early detection is important to ensure effective management.

During diagnosis, your healthcare provider will perform these two blood tests:

  • Serology testing: This test assesses the antibodies in the blood. A rise in the levels of specific antibody proteins implies an immune response to gluten.
  • Genetic testing: This can be done to check for human leukocyte antigens (HLA-DQ2 and HLA-DQ8), which could help rule out celiac disease.

Testing celiac disease before adopting a gluten-free diet is crucial. Basically, a gluten-free diet could skew blood test results, making them appear within the standard range. 

In case the outcome of the blood test suggests celiac disease, your medical practitioner might order one of these procedures:

  • Endoscopy: This diagnostic test involves putting a long tube equipped with a small camera into the mouth and passing it down the throat. The medical practitioner will examine the small intestine through the camera. A small tissue sample can also be removed (biopsy) to assess the villi damage.
  • Capsule endoscopy: This procedure utilizes a small wireless camera placed in a vitamin-sized pill that is usually swallowed. The camera captures countless images as it travels through the digestive tract, which will then be transferred to a recorder. Mostly, this test is recommended in cases where an examination of the end of the whole small intestine is necessary.

For people suspected to have dermatitis herpetiformis, the doctor can remove a small skin tissue sample for microscope examination.

Upon diagnosis of celiac disease, more tests may be performed to evaluate the nutritional status, including the levels of minerals, vitamins (A, B-12, D, E), liver enzymes, and hemoglobin. A bone density scan might also be conducted to check your bone health.

What is the Connection between Celiac Disease and Gluten?

Generally, gluten is the main component in the onset and treatment of celiac disease. The immune system of people with the condition responds to gluten consumption by creating antibodies, which attack the small intestine lining. This immune reaction usually damages the villa and causes inflammation, impairing nutrient absorption.

For that reason, those with celiac disease should strictly eliminate gluten, such as cereals, pasta, bread, or baked foods containing wheat, barley, and rye. Also, checking all food labels and preventing cross-contamination is essential. This is because even small traces of gluten could provoke a reaction.

Celiac Disease Treatment

The primary treatment for celiac disease is total elimination of gluten from your diet. Even though you cannot alter how your body responds, you can stop gluten from provoking that reaction. Furthermore, avoiding gluten allows your small intestine to heal and eventually resume normal absorption of nutrients. However, you need to observe a strict lifelong gluten-free diet to prevent yet another damage.

Other celiac disease treatment options may include:

  • Nutritional supplements to substitute for any severe deficiencies.
  • Medications like dapsone to treat dermatitis herpetiformis.
  • Corticosteroids to manage severe inflammation that does not respond quickly to the diet.
  • Constant follow-up care, along with routine testing to ensure the disease in under control.

Living With

While living with celiac disease might be challenging, these tips will help you:

  • Create a go-to home menu: Look through guides and find a few favorite and easy-to-prepare gluten-free recipes. Also, ensure that you keep the ingredients at home so you don’t have to worry about what to cook or eat.
  • Select reliable restaurants: Spot your favorite reliable restaurants that serve gluten-free meals. You can also look at the menus online beforehand and consult with the staff if necessary to ensure they can accommodate your dietary needs.
  • Keep gluten-free snacks on hand: You should always have a few gluten-free snacks in the bag, car, or even office desk to ensure you have something safe to eat even when you are away from home.
  • Carry gluten test strips: This will help you check the gluten content of foods you aren’t sure of what they contain.

Effects of celiac disease on mental health

Celiac disease doesn’t only affect a person’s physical health but can also cause major impacts on mental health. The condition’s chronic nature, food restrictions, and possible social limits could result in a feeling of depression, anxiety, or even social isolation. Furthermore, nutrient deficiencies caused by malabsorption might contribute to mood swings and cognitive function.

Generally, it’s important for people diagnosed with celiac disease to seek assistance from medical specialists, mental health organizations, and support groups. Dealing with psychological and emotional aspects of managing the condition helps cope well with challenges that may arise and enhances overall well-being.

Celiac Disease Management

Besides adhering to a strict gluten-free diet, taking medications to help manage symptoms or addressing certain complications may be necessary. For instance, the doctor may prescribe corticosteroids or immunosuppressant medications for people with refractory celiac disease to control immune reactions and lower inflammation.

Keep in mind that you should always use medications under a doctor’s guidance. Moreover, the treatment plans will depend on a person’s needs and medical history. Routine follow-up visits are also important to monitor the medicine’s effectiveness and make certain changes if necessary.


Overall, it is essential for people with celiac disease and medical practitioners to understand the condition. Celiac disease is a chronic autoimmune illness caused by gluten consumption. It affects the small intestine, resulting in inflammation and damage. Early intervention is thus crucial to avoid long-term complications and enhance general life quality.