Celiac.com 06/05/2015 - For anyone with celiac disease, following a lifelong gluten-free diet has been shown to relieve symptoms, and in celiac patients it has been shown to normalize serologic markers of celiac disease, and to restore damaged intestinal villi.

Photo: CC--MeridicanNot following a gluten-free diet, on the other hand, can result in serious complications associated with malabsorption.

When celiac disease goes untreated, when people who have celiac disease refuse to follow a gluten-free diet, chronic gluten-related inflammation and damage impairs absorption of nutrients, and likely causes malabsorption of oral medications.

Malabsorption resulting from damaged mucosa can lead to:

  1. Nutritional deficiencies of the fat-soluble vitamins A, D, E, and K, as well as the B vitamins, thereby diminishing the absorption of iron, calcium, and folic acid. Nutritional deficiencies can lead to:
  2. Iron-deficiency anemia refractory to oral iron supplementation, and potentially osteoporosis and osteopenia due to bone loss due to decreased calcium and vitamin D absorption. A combination of nutritional deficiencies and the damaging effects of systemwide chronic inflammation can cause:
  3. Reproductive abnormalities, such as delayed puberty, secondary amenorrhea, infertility, or decreased fertility. Adverse immune responses to gluten ingestion can trigger other common manifestations, such as:
  4. Dermatitis herpetiformis, a papulovesicular rash. Beyond that, problems can include:
  5. Fractures secondary to low bone mineral density. In some cases, untreated celiac disease can lead to intestinal malignancies such as:
  6. Intestinal T-cell lymphomas.
  7. Small-bowel adenocarcinoma.
  8. Esophageal cancer.
  9. B- and T-cell non-Hodgkin lymphomas.

Rapid, proper diagnosis and effective treatment of celiac disease are crucial to preventing a cascade of related problems that can further impair diagnosis, and cause irreparable damage to patient health.


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