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Topic Overview

If celiac disease is left untreated, complications may develop. Some of these problems can occur because of the small intestine's inability to digest food and absorb nutrients properly. Other problems may develop from damage to the intestinal lining that may or may not cause noticeable symptoms.

In children, celiac disease may produce noticeable and more severe symptoms than in some adults. Even though symptoms are often milder in teens and adults, they may also have complications, although some teen and adult complications are different from those that affect children.

Complications in children

Children who have untreated celiac disease may develop complications such as:

• Weight loss and failure to grow, also known as failure to thrive. A child may be short for his or her age and have small, undeveloped muscles of the buttocks, arms, and legs. A child's belly may appear swollen. Even if a child eats well, his or her weight is usually below normal.
• Rickets or osteoporosis. These conditions may develop because the body does not absorb enough calcium and vitamin D.
• Iron deficiency anemia. Children who have celiac disease are at increased risk for developing iron deficiency anemia because their intestines are not able to absorb enough iron.
• Loss of tooth enamel. Enamel may not form normally on the teeth, leaving them soft and yellow.
• Folic acid deficiency anemia. This condition may develop if the body absorbs too little of the B vitamin folic acid.
• Intussusception. Celiac disease may damage the intestines, causing this condition to occur.
• Rectal prolapse. This condition of the large intestine may develop with severe celiac disease.

Complications in teens

Teens who have untreated celiac disease can have many of the same problems as those in younger children. In addition, they may have:

• Delays in growth. Teens may be short and underweight for their age.
• Delay of puberty. Menstrual periods may start later than normal in girls. Facial hair growth and voice changes may occur late in boys.

It is sometimes hard for teens to consistently follow a gluten-free diet. Make sure your teen knows that the more he or she doesn't follow the diet, the more likely the above complications are to develop.

Complications in adults

Adults who have celiac disease may develop complications such as:

• Refractory disease. You may have refractory sprue if you continue to have symptoms even after starting a gluten-free diet, or if you get better after starting a gluten-free diet, and stay better for a while but your symptoms come back even though you are still eating a gluten-free diet.
• Blockage or sores (ulcerations) in the small intestine.
• Iron deficiency anemia and folic acid deficiency anemia.
• Osteoporosis.
• Infertility.
• Recurrent miscarriages.
• Absence of menstrual periods (amenorrhea).
• Anxiety and depression.
• Lymphoma of the intestine and possibly cancer of the esophagus.