Celiac disease (CD), triggered by the ingestion of gluten, occurs in people genetically predisposed to develop the chronic autoimmune condition.
During the past few decades, doctors have learned much about how the disease develops, including genetic and other risk factors. However, results from studies on whether people with CD have an increased risk of premature death linked to the condition have been mixed. A recent study shows a small but statistically significant increased mortality rate.
Celiac disease can affect the entire body
Until recently, CD was considered a mainly pediatric gastrointestinal disorder, associated with symptoms of abdominal pain, diarrhea, constipation, and bloating, and characterized by damage to the villi of the small intestine. (Villi are tiny, fingerlike projections lining the small intestine that help the body absorb nutrients.)
With the development of accurate blood tests and large-scale screenings, we have identified CD as a truly systemic disorder that can develop at any age and affect nearly any tissue or organ in the body. People with CD may experience joint pain, osteopenia or osteoporosis, bone fracture, rash, and psychiatric symptoms such as anxiety and depression.
The environmental trigger for CD — gluten — is known. When we remove gluten (a protein found in wheat, rye, and barley) from the diet of people with CD, they usually experience an improvement or resolution of symptoms. Their blood tests return to normal and their small intestine heals.
Celiac disease may affect life expectancy
Studies evaluating CD and mortality have had conflicting results, with some studies showing up to a twofold increase in mortality, and others showing no increased risk. In addition, we have not yet identified how CD may alter life expectancy. Some think that it might be partly related to chronic inflammation, leading to the development of osteopenia and bone fractures, complications from associated conditions such as type 1 diabetes, or rarely, the development of intestinal lymphoma (a type of cancer).
A recent study published in JAMA found a small but significant increased risk of mortality in people with CD. Interestingly, people with CD were at an increased risk of death in all age groups studied, but mortality was greater in those diagnosed between the ages of 18 and 39. Researchers found that the risk of death was increased in the first year after diagnosis, b