Celiac Disease and Cryptogenic Cirrhosis: A Hidden Connection

Celiac.com 03/29/2025 - Celiac disease is an autoimmune condition that primarily affects the small intestine but can also have widespread effects on other organs, including the liver. Some individuals develop liver damage without a clear underlying cause, a condition known as cryptogenic cirrhosis. A recent study published in The American Journal of Gastroenterology explores the link between celiac disease and cryptogenic cirrhosis, investigating how common celiac disease is in these patients and whether a gluten-free diet can improve liver function.

Study Overview

The researchers screened 300 individuals with chronic liver disease that had no known cause. After further evaluation, 232 patients were confirmed to have cryptogenic cirrhosis. These patients underwent blood tests to check for antibodies associated with celiac disease, as well as small intestine biopsies to confirm the diagnosis.

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Out of the 232 patients:

• 11 were diagnosed with celiac disease based on biopsy results
• 5 had elevated celiac disease-related antibodies but did not show enough intestinal damage to be definitively diagnosed
• 216 had no signs of celiac disease

For comparison, the study also included a control group of 44 patients with cryptogenic cirrhosis who did not have celiac disease.

Key Findings

Prevalence of Celiac Disease in Cryptogenic Cirrhosis

The study found that about 4.7% of the cryptogenic cirrhosis patients had biopsy-confirmed celiac disease, while 6.9% had positive blood tests indicating possible celiac disease. This suggests that celiac disease might be an overlooked cause of liver disease in some individuals.

Liver Health and the Gluten-Free Diet

To evaluate the impact of diet, researchers tracked two groups for one year:

1. Patients with celiac disease who adopted a gluten-free diet
2. Patients with cryptogenic cirrhosis without celiac disease who followed standard medical care

The results showed that patients with celiac disease who removed gluten from their diet experienced significant liver function improvement. Key measurements of liver health, including the Model for End-Stage Liver Disease score and Child-Pugh score, improved in the gluten-free diet group. In contrast, the patients who did not have celiac disease and followed standard care showed worsening liver function over time.

Additionally, individuals with celiac disease who adhered to a gluten-free diet had fewer complications related to liver disease. The death rate was similar between groups, suggesting that while a gluten-free diet did not reduce overall mortality in the short term, it significantly improved quality of life and liver function.

Why This Study Matters

Uncovering Hidden Celiac Disease in Liver Patients

For individuals with unexplained liver disease, this study highlights the importance of testing for celiac disease. Many doctors may not immediately consider celiac disease when diagnosing liver issues, but this research suggests that it could be a contributing factor in a notable percentage of cases.

A Gluten-Free Diet Can Be a Game Changer

One of the most promising takeaways from this study is that treating celiac disease with a strict gluten-free diet can lead to real improvements in liver health. Unlike many liver diseases that have limited treatment options, this study suggests that dietary changes alone can make a significant difference for some patients.

Implications for People with Celiac Disease

For individuals who already have a celiac disease diagnosis, this study serves as a reminder that liver health should not be overlooked. If someone with celiac disease is experiencing abnormal liver test results or signs of liver damage, it may be worth discussing cryptogenic cirrhosis with a healthcare provider.

Final Thoughts

This study sheds light on an important but underrecognized connection between celiac disease and liver health. It suggests that celiac disease testing should be considered for individuals with unexplained liver disease, as identifying and managing celiac disease through a gluten-free diet can lead to meaningful health improvements. For those living with celiac disease, it reinforces the importance of dietary adherence—not just for digestive health but for overall well-being, including liver function.

Read more at: journals.lww.com