Coeliac disease requires ongoing review and management. People with undiagnosed coeliac disease, or those with coeliac disease who are not following a strict gluten-free diet, are at higher risk of certain complications.
Bone problems
If coeliac disease is undiagnosed or not treated by following a strict gluten-free diet, decreased absorption of calcium may result. This puts a person at greater risk of osteoporosis, a condition where bones become thin and more likely to break.
The strength of bones is measured by measuring bone mineral density (BMD). Osteopenia is a condition where BMD is lower than normal, but not as severe as in osteoporosis.
There have been a number of reports showing evidence of reduced BMD, osteopenia or osteoporosis in 20–50 per cent of people newly diagnosed with coeliac disease. This is largely thought to be related to long-term malabsorption of calcium as a result of delayed diagnosis of coeliac disease.
Maintaining bone health
If you are diagnosed in childhood or during your teenage years and you follow a gluten-free diet, your long-term bone health is likely to be unaffected.
Following a healthy lifestyle and a healthy balanced gluten-free diet containing rich sources of calcium is vital for bone health. Your dietitian and healthcare team will be able to discuss in greater detail what steps you need to take for optimal bone health.
You will not be able to feel your bones thinning, so if you think that you are at risk of osteoporosis, it is advisable to discuss this with your GP.
Cancer, infertility, poorer pregnancy outcomes
Certain kinds of gut cancer, infertility and poorer outcomes in pregnancy are associated with coeliac disease.
Again, following a lifelong gluten-free diet reduces your risk.
Once a gluten-free diet has been followed for 3–5 years, the risk of developing cancer is no greater in comparison to the general population.
The risks of infertility and poorer outcomes in pregnancy are also reduced following diagnosis and keeping to a gluten-free diet.
Reviewed March 2010
Next review September 2011