What Are the Complications of Celiac Disease?

Medically Reviewed by Minesh Khatri, MD on November 27, 2022
3 min read

When you have celiac disease, your body has a major problem with gluten. For reasons that scientists don’t completely understand, gluten makes your immune system attack the lining of the small intestine if you have this condition. This causes serious damage and problems that can go beyond the digestive system.

To prevent that, you need to be on a gluten-free diet. Once gluten is out of the picture, your small intestine will start to heal.

But because celiac disease is so hard to diagnose, people can have it for years. This long-term damage to the small intestine may start to affect other parts of the body.

Many of these problems will go away with a gluten-free diet. Your recovery time will depend on how long you’ve been dealing with the complications. But depending how much damage has been done, infertility and bone weakness often don’t reverse.

These problems could happen:

Lactose intolerance. The small intestine digests lactose, which is the sugar naturally found in milk. If your small intestine doesn’t work right because of celiac disease, you might become lactose intolerant.

Vitamin and mineral deficiencies. When the small intestine is damaged, it can’t absorb vitamins and minerals. People with untreated celiac disease often are low in these:

Osteopenia and osteoporosis. When your body lacks calcium, your bones can become brittle. If your small intestine doesn’t heal and you continue to miss out on it, you might develop osteopenia (low bone density) and then osteoporosis, where your bones are weaker.

Iron deficiency anemia. Your body needs iron to make red blood cells, which carry oxygen around the body. If you don’t have enough iron and your blood doesn’t have enough oxygen, this can make you tired and short of breath.

Researchers also have found connections between celiac and these conditions:

Lymphoma. Celiac disease is an immune system condition, and lymphocytes are part of the immune system, so it’s possible that a condition like celiac disease could cause cancer in those cells. Keep in mind that not everyone with celiac disease will get lymphoma. You may be more likely to get this cancer if you find out you have the condition later in life and have more damage to your intestines.

Fertility problems. Women with uncontrolled celiac disease can have a hard time getting pregnant, and they may be more likely to miscarry.

Nervous system disorders. People with celiac disease are more likely to have nerve problems (neuropathy) and problems with controlling their movement (ataxia). Lack of vitamins and minerals might cause this. Or it could be that they also have another immune system problem.

The small intestine is in constant communication with other parts of the body. Many people with celiac disease also have liver, gall bladder, and pancreas conditions. Those with untreated or undiagnosed celiac disease might have anxiety and/or depression. But it’s not clear if celiac disease or something else causes those problems.

A child who has celiac disease that a doctor hasn’t yet found might be small and underweight. They might have weak tooth enamel and a condition called intussusception, which causes the intestines to fold in on themselves. There’s also a chance of delayed puberty. So the sooner your child is diagnosed and gets on a gluten-free diet, the better.