Long-term health effects of celiac disease.

Celiac disease (CD) is an autoimmune and systemic condition affecting the small intestine that is triggered by gluten ingestion in genetically predisposed individuals. Although there are no apparent symptoms, continued exposure to gluten causes damage to the intestine and malabsorption, opening the door to a number of long-term health complications.

Eliminating gluten from the diet can alleviate symptoms and reverse intestinal inflammation, but involves constant vigilance and discipline on the part of the individual.

It is important that celiac disease be diagnosed and treated as early as possible. Early diagnosis can have many advantages over diagnosis in adulthood. Some of the differences between early and adult diagnosis are:

• Long-term health complications: If celiac disease goes undiagnosed and untreated for a prolonged period of time, there may be an increased risk of long-term complications, such as anemia, osteoporosis, infertility, small bowel cancer and other health problems related to nutrient deficiencies.

• Growth and development: Children who are not adequately treated for celiac disease may have growth and developmental problems, such as stunted growth, short stature and delayed puberty.

• Difficulty adjusting to a gluten-free diet: People diagnosed with celiac disease in adulthood may have more difficulty adapting to a gluten-free diet due to the need to change eating habits that have developed over time.

• Increased awareness and better knowledge of the disease: Early diagnosis can allow patients to have greater awareness of the disease and develop a stronger understanding of how to live with celiac disease and avoid gluten.

Medical conditions that celiacs may develop.

Among the medical conditions that celiacs may develop are:

• Anemia: a condition in which there are not enough healthy red blood cells. Nearly half of celiacs have anemia.

• Malnutrition: lack of sufficient nutrients in the body that prevent it from functioning optimally.

• Osteoporosis: one of the main long-term complications of celiac disease is osteoporosis, a condition that weakens bones and increases the risk of fractures. Poor absorption of calcium and vitamin D due to chronic inflammation of the intestine can contribute to bone loss.

• Autoimmune diseases: CD may increase the risk of autoimmune diseases.

Among the most prominent are:

• Type 1 diabetes mellitus: type 1 diabetes is an autoimmune disease in which the immune system attacks and destroys insulin-producing cells in the pancreas. Some studies suggest that people with celiac disease have an increased risk of developing this type of diabetes. This is thought to be due to a shared genetic predisposition and similar autoimmune response to both disorders.

• Hashimoto's thyroiditis: autoimmune thyroiditis is a chronic inflammation of the thyroid that can cause hypothyroidism.

• Systemic lupus erythematosus (SLE) is a chronic disease in which the immune system attacks healthy tissue and causes inflammation in organs. It is common for the joints to be affected.

• Dermatitis herpetiformis: blisters usually appear on elbows, knees, back and buttocks. It is a manifestation of celiac disease.

• Gluten ataxia: this is a condition that is still under investigation but has been linked to celiac disease, as a significant number of sufferers share the same genetic variant that predisposes to CD. In ataxia, antibodies attack the cerebellum area causing neurological damage.

Cancer: chronic inflammation of the intestine and malabsorption of nutrients can damage the DNA of cells and increase the likelihood of cancerous mutations. People with CD should be screened regularly, especially if they have a family history. In addition, people with untreated CD may also have iron and folate deficiencies, which can further increase the risk of cancer. CD and some types of cancer have been shown to share certain genes and inflammatory pathways that may contribute to cancer development. They may have an increased risk of developing small bowel adenocarcinoma and colorectal cancer. Non-Hodgkin's lymphoma (NHL), which affects the small intestine, has also been linked to CD.

Reproductive complications: This disease can also affect reproductive health. Women with untreated celiac disease have an increased risk of miscarriage, premature delivery, and low birth weight compared to women without the condition. In addition, untreated celiac disease in children can affect growth and neurological development, which can result in delays in speech, coordination and learning.

Lactose intolerance: the reason for this association is not completely clear, but it is thought that it may be related to the inflammation and intestinal damage that occurs in celiac disease, which can interfere with the production of lactase, the enzyme that digests lactose. It is usually reversible for celiacs once the intestine heals and the villi recover.

Peripheral neuropathy: this condition has also been linked to CD. It causes weakness, numbness and pain, usually in the hands and feet, caused by nerve damage.

Liver disease: CD is a major cause