Celiac Disease: Causes, Complications, Diagnosis, and Treatment

Disease Definition and Causes

Celiac disease, also known as gluten-sensitive enteropathy, is a condition that affects adults, where the small intestine fails to produce certain enzymes necessary to break down gluten. This leads to disruptions in digestive functions and the emergence of uncomfortable symptoms upon consuming any gluten-containing food. Gastroenterologists evaluate symptoms, diagnose, and treat celiac disease in adults in collaboration with geneticists and other specialists.

About the Disease:
Celiac disease, or gluten-sensitive enteropathy, is an autoimmune condition inherited genetically and primarily manifests in women at a rate twice that of men. The body’s immune defenses perceive gluten as a hostile element, triggering an inflammatory process in the small intestine. As a result, the absorption of nutrients is affected, leading to weight loss, general depletion, and signs of digestive disorders in adults with celiac disease.

Types of Celiac Disease:
Celiac disease classification distinguishes several types based on various criteria. According to clinical signs, gluten-sensitive enteropathy can be categorized as:

  • Typical type, which appears in childhood between two and three years of age with characteristic symptoms.
  • Silent type, where the disease manifests at different times in the patient’s life, with external symptoms being prominent (bleeding gums, osteoporosis, etc.).
  • Latent type, where the disease develops without clear symptoms, most common in older adults.

Based on the stages of development and the degree of inflammation activity in the digestive system, doctors distinguish the following types of celiac disease:

  • Latent stage: characterized by no clear signs of the disease despite the beginning of the inflammatory process.
  • Active stage: where typical gluten sensitivity signs appear (digestive disorders, bloating, diarrhea, etc.).
  • Partial remission stage: where most symptoms disappear due to treatment, but the inflammatory process has not been completely suppressed.
  • Complete remission stage: where the disease is completely controlled, and signs of gluten-sensitive enteropathy disappear.
  • Relapse stage: where symptoms of the disease reappear after a period of improvement.

If you notice similar symptoms, consult your doctor. Do not self-medicate, as it poses a risk to your health!


Symptoms of gluten intolerance in adults primarily accompany digestive system effects, including:

  • Increased gas production.
  • Frequent diarrhea.
  • Abdominal pain after eating.
  • Rapid fatigue.
  • Abdominal bloating and swelling.
  • Feeling heavy after meals.

A distinctive sign of gluten intolerance is the peculiar structure and greasy texture of stools, which are difficult to wipe and leave hard-to-clean stains on undergarments when cleanliness is lacking.

Over time, celiac disease symptoms may evolve and include:

  • Anemia.
  • Weight loss.
  • Softening and thinning of bones (osteoporosis).
  • Darkening of tooth enamel.
  • Recurrent headaches.
  • Chronic fatigue.
  • Appearance of itchy blisters.
  • Persistent heartburn.
  • Joint pain.
  • Muscle weakness.
  • Continuous abdominal rumbling.
  • Uncomfortable burping.

In an active stage of gluten-sensitive enteropathy, various neurological signs may also appear, including:

  • Numbness in extremities.
  • Nerve damage.
  • Tingling or prickling sensations on the skin.
  • Coordination disorders.
  • Decreased concentration and memory.

This condition may be accompanied by increased drowsiness and decreased performance, as the patient finds it difficult to focus on practical tasks. Some patients struggle to absorb new information and have difficulty acquiring additional skills or adapting to changes in the surrounding work environment. Due to bone thinning and fragility, frequent fractures may occur, taking a long time to heal.


The main reason for celiac disease is a genetic defect that leads to an exaggerated immune reaction to gluten. Some studies have shown that under certain conditions, intolerance to this peptide can evolve into an independent autoimmune process in the background of other diseases such as diabetes, systemic lupus erythematosus, thyroiditis, and so on.

Consumption of foods containing grains like barley, oats, and wheat triggers the manifestation of the disease. These foods include:

  • Bread products.
  • Pasta.
  • Baked desserts.
  • Ice cream.
  • Flour-containing sweets.
  • Thick sauces and salad dressings.
  • Dry breakfasts.
  • Fast-food meals.
  • Preservatives.
  • Beer.

Gluten is used as a thickener in the production of many products, so consuming any food without considering it can activate the inflammatory process.

Complications of Celiac Disease (Digestive Disorders)
Complications of celiac disease (gluten sensitivity) often develop in adults who have an atypical pattern of the disease after many years of onset. Among these complications are:

  • Skin changes: Herpetic dermatitis, atopic dermatitis, vitiligo, hair loss, mouth ulcers, lip inflammation.
  • Risk of developing gastrointestinal cancer – the leading cause of death in 10-50% of celiac patients. The development of small intestine cancer tends to occur not only in individuals with gluten intolerance but also in their close relatives: mothers, fathers, siblings.
  • Multiple ulcers in the small intestine – such as duodenal inflammation (for the small intestine), Crohn’s disease, accompanied by fever, rapid weight loss, diarrhea, and abdominal pain. Ulcers can be complicated, with bleeding and scar formation, eventually leading to intestinal obstruction – a severe surgical condition requiring immediate care.
  • Irregular bowel movements – a condition in which normal peristaltic movements of the intestinal wall temporarily stop. Unlike the acute form, this complication can be overcome without surgical intervention. Patients suffer from nausea, vomiting, constipation, and abdominal pain.
  • Refractory celiac disease – continuous damage to the small intestine with distinctive symptoms, despite strict adherence to a gluten-free diet. This type of disease does not respond to treatment, and its mechanism of development is not fully understood.

Skeletal System

  • Secondary osteoporosis – chronic bone injury. It often develops in women after menopause after 10 years, and sometimes occurs in children before school age and young people. In the case of celiac disease, important nutrients for bone growth, including calcium and vitamin D, are not absorbed alone. Due to their chronic deficiency, bone tissue cannot renew its stock, leading to reduced density, i.e., osteoporosis.
  • Infertility – Infertility occurs more commonly in adult patients without a clear clinical picture of the intestine, i.e., while having an atypical pattern of celiac disease. It is also associated with a decrease in the absorption of essential nutrients for normal pregnancy: folic acid, iron, vitamin D, and calcium. With adherence to a gluten-free diet, the mucous membranes recover, and necessary absorption occurs. There is no need to follow a gluten-free diet without confirming the diagnosis of celiac disease.
  • Epilepsy – Epilepsy commonly occurs in celiac patients, and vice versa. Both are also associated with nutrient deficiencies, specifically folate deficiency, leading to calcium accumulation in the brain substance. If children with epilepsy have vague manifestations of celiac disease, epilepsy treatment without celiac disease treatment may not be effective.
  • Since the genetic defect in the body often affects more than one gene, celiac disease may be associated with other autoimmune and hereditary diseases. These diseases include:
  • Type 1 diabetes.
  • Autoimmune thyroid gland-related diseases – usually autoimmune thyroiditis.
  • Addison’s disease – destruction of the adrenal cortex, characterized by vomiting, diarrhea, loss of appetite, weight loss, low blood glucose levels, and increased need for salty food.
  • Reproductive system disorders – infertility, menstrual cycle disorders, absence of menstruation due to low weight.
  • Heart and blood vessel problems – autoimmune myocarditis and others.
  • These disorders demonstrate the balance between the immune system and genes, so celiac disease may be associated with a variety of other diseases.


During the initial examination, the doctor performs a physical examination, evaluates the patient’s skin and teeth appearance, and asks about complaints. Collecting medical history is crucial in diagnosing celiac disease: during patient questioning, it is found in 95% of cases that they have similar problems faced by close relatives. The doctor also needs to know the nature of nutrition and its characteristics, lifestyle, and the presence of other diseases.
Laboratory methods for diagnosing gluten intolerance include:

  • Chemical blood analysis, which helps detect albumin deficiency, anemia, and deficiency of key nutrients and minerals.
  • Determination of the concentration of specific antibodies formed in the case of celiac disease (tissue transglutaminase, gliadin peptides).
  • Schilling test or other studies that allow assessing the quality of absorption in the small intestine.
    If necessary, endoscopic examination of the small intestine with sampling is also performed. Abdominal ultrasound, computer or magnetic resonance imaging as needed, and X-ray imaging of the intestines using a whitening substance also show.

The treatment strategy depends on the type of celiac disease, the stage of the inflammatory process, the severity of clinical symptoms, and other factors. The basic condition for effective treatment is complete avoidance of consuming products containing gluten. Products containing wheat, barley, oats, or several grains are prohibited. It is very important to carefully examine the composition of any new products before purchasing or consuming them, as indicated on the package.
Traces of gluten may be found in products such as:

  • Ground meat and sausages.
  • Ready-to-eat chilled and frozen meat and vegetable foods.
  • Fast-food products.
  • Instant coffee.
  • Cocoa.
  • Soy milk and derivatives.
  • Dry breakfasts.
  • Mayonnaise.
  • Ketchup.
  • Sauces and vegetable sauces.
  • Canned fish and meat dishes.
  • Chocolate.
  • Gummy candies and caramels.
  • Broth cubes and other concentrates.
  • Ice cream.
  • Beer.
    In addition to modifying the diet and strict diet in the case of celiac disease, drug treatment is administered, including hormone medications and anti-inflammatory drugs to suppress the inflammatory process in the small intestine. Vitamin and mineral supplements and dietary supplements can also be used to restore the balance of nutrients in the body.
    It is also necessary to monitor and treat any other existing diseases in the patient appropriately.
  1. Smirnova, M.A. Introducing a new algorithm for the diagnosis of Celiac Disease, published by ZAO “BioKhimMak” in Moscow in 2002.
  2. Romanovskaya, I.E. Presenting a handbook tailored for individuals with Celiac Disease, published by GAOORDI in St. Petersburg in 2001.
  3. The National Institutes of Health Consensus Development Conference on Celiac Disease: Final Statement, held on June 28-30, 2004.