Celiac disease, an autoimmune disorder triggered by gluten, profoundly impacts the digestive system.

When someone with celiac disease consumes gluten, the immune system mistakenly targets the lining of the small intestine, resulting in inflammation and damage.

The Mechanism Behind the Damage

At the core of celiac disease lies an immune response that attacks the small intestine. When individuals with celiac disease ingest foods containing gluten—a protein found in wheat, barley, and rye—their immune system erroneously identifies gluten as a harmful substance.

In response, the body produces antibodies that target and damage the villi, the finger-like projections that line the small intestine. These villi are essential for nutrient absorption, so when they are damaged, the body struggles to absorb essential vitamins and minerals.

Digestive Symptoms and Complications

The effects of this damage are not only limited to the gut, they cascade into various digestive issues and systemic problems. The most common digestive symptoms associated with celiac disease include:

Chronic diarrhea or constipation: The damage to the small intestine can disrupt the normal movement of food through the digestive tract, leading to irregular bowel movements.

Bloating and gas: The inflammation and malabsorption often cause bloating and excessive gas, as the gut struggles to process food.

Abdominal pain and cramps: Inflammation in the intestine can cause discomfort and sharp pains, especially after eating foods containing gluten.

More severe cases may lead to complications such as lactose intolerance, where the body cannot properly digest lactose, and small intestinal bacterial overgrowth (SIBO), a condition where excessive bacteria populate the small intestine, leading to further digestive distress.

Nutrient Deficiencies: The Silent Consequences

The damage to the villi impedes the absorption of critical nutrients, leading to several health issues.

Christen Cupples Cooper, MS, RD, a registered dietitian and celiac disease specialist, explains, "Individuals with untreated celiac disease often face iron-deficiency anemia due to poor absorption of iron, a key component in red blood cell production." In addition to iron, people with celiac disease may develop deficiencies in vitamin D, calcium, folate, and vitamin B12. These deficiencies can result in:

Osteoporosis or osteopenia: Calcium and vitamin D are essential for bones health, and their deficiency can lead to weakened bones.

Neurological issues: Lack of vitamin B12 can cause neurological problems like numbness, tingling, and cognitive dysfunction.

Skin rashes: Malabsorption of essential fatty acids and vitamins can manifest as dermatitis herpetiformis, a blistering, itchy rash often seen in people with celiac disease.

Long-Term Digestive Impacts

When left undiagnosed or untreated, celiac disease can cause long-term damage to the digestive system. Chronic inflammation in the small intestine increases the risk of developing small bowel lymphoma and intestinal adenocarcinoma, both of which are types of cancer that may arise due to ongoing immune system activity and cellular damage.

Additionally, persistent inflammation can lead to a leaky gut, a condition where the intestinal lining becomes more permeable, allowing undigested food particles and toxins to leak into the bloodstream, potentially triggering systemic inflammation.

The Importance of a Gluten-Free Diet

The primary treatment for celiac disease is a strict, lifelong gluten-free diet. This diet helps heal the damaged villi and prevents further immune system attacks. However, achieving complete healing can take time, with some individuals requiring months or even years to fully recover, depending on the severity of their condition.

Celiac disease affects the digestive system in profound and often debilitating ways. From chronic digestive discomfort to severe nutrient deficiencies, its impact extends far beyond the gut.

However, with proper diagnosis and adherence to a gluten-free diet, most individuals can manage their symptoms and lead healthy lives. As research into celiac disease continues to evolve, the hope is that better treatments and potentially a cure will emerge, improving the quality of life for those affected by this challenging condition.

With understanding the physiological mechanisms at play and the importance of early intervention, we can better support individuals with celiac disease and provide them with the resources they need to manage their condition effectively.