Complications & Prognosis of Coeliac Disease! :(

1. Malabsorption

Small intestine is responsible for absorption of nutrients mainly Vit B12, iron, Vit K, Calcium and Vit D. As small bowel is inflamed, vital nutrients are lost in stools rather than absorbed in blood stream, leading to deficiency in vitamins and minerals.

2. Lactose Intolerance

Lactase enzyme is synthesise in cells lining the villi and is responsible for digesting lactose. As villi shrink and damaged in celiac disease, patients will face problems with digesting lactose. It will heal off once they start on gluten-free diet.

3. Cancer

Untreated celiac disease has shown to lead to lymphoma (enteropathy associated T cell lymphoma with poor prognosis) and adenocarcinoma of esophagus, pancreas, small and large intestine and hepatobiliary tract even though it is rare. Symptoms of small intestinal lymphoma include anemia, bleeding into intestine, abd pain, weight loss, fever and small intestine obstruction. Often difficult to diagnose.

4. Miscarriage and congenital malformation of unborn baby

Pregnant women do not realize they have celiac disease or do not follow gluten free diet if they have it have nutrient absorption problems that can lead to miscarriage and congenital malformations such as neural tube defects (Folate deficiency).

5. Ulcerative jejunoileitis

Rare complication of celiac disease. Recurrent episodes of small intestines insult leading to formation of strictures. Symptoms of jejunoileitis can be intestinal bleeding, weight loss, abd pain and intestinal obstruction. Individuals with ulcerative jejunoileitis are at high risk of developing intestinal lymphomas.

6. Refractory Celiac Disease

Rare condition which symptoms of celiac disease despite strict adherence to gluten-free diet. Occurs in approximately 5% of patients. Subdivided into 2 types: type 1 is characterized by normal intraepithelial lymphocytes phenotype and type 2 is characterized with increase number of intraepithelial lymphocytes, due to increase in epithelial interleukin 15 expression.

7. Collagenous Celiac Disease

Have symptoms of celiac disease but fail to improve on gluten-free diet. Large amount of collagen forms under intestinal lining after several years and prognosis is poor.