Celiac disease is a hereditary genetic condition. People with a first-degree relative with celiac disease, such as a parent, have a higher risk of developing it.

Celiac disease is an autoimmune condition. When people with celiac disease eat gluten, it damages the lining of the small intestine and can lead to serious problems with nutritional malabsorption.

Gluten is the protein in grains such as wheat, rye, and barley. There is a vast array of foods containing gluten, including:

  • bread
  • baked goods
  • processed foods

Although experts estimate that celiac disease affects 1 in 100 people worldwide, only about 30% have a diagnosis from a doctor.

It only affects people with specific genetic features, but not everyone with these features will develop it.

This article discusses hereditary celiac disease and explains how it occurs. It also explores other causes of celiac disease and if it is possible to prevent it. Finally, we also explain potential complications and how doctors treat the condition.

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People with a first-degree relative, such as a parent, child, or sibling, have a 1 in 10 risk of developing celiac disease. The disease can occur at any age after someone starts consuming gluten.

The Genetic and Rare Diseases Information Center explains that while celiac disease runs in families, it does not follow a specific inheritance pattern.

Specific genes and chromosomal disorders

However, the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) notes that celiac disease can only occur in people whose DNA harbor specific genes.

There is an increased risk of celiac disease if someone has certain forms of the human leukocyte antigen (HLA)-DQA1 and HLA-DQB1 genes.

The NIDDK advises that celiac disease may occur in some people with one of two gene variants: DQ2 and DQ8. People who do not have these gene variants are very unlikely to develop celiac disease.

Although about 30% of people have DQ2 or DQ8, only 3% will develop celiac disease. Researchers from the NIDDK are studying which other genes may trigger the condition in people with DQ2 or DQ8.

Celiac disease is also more common in people with certain chromosomal disorders, such as:

While genes are the main cause of someone developing celiac disease, the NIDDK notes that scientists are studying other factors which may raise a person’s chance of developing the disease.

Research suggests that these risk factors may include having more infections early in life. Additionally, digestive tract infections and gut bacteria changes may contribute to the disease’s development.

Doctors treat celiac disease by recommending a gluten-free diet.

The NIDDK explains that following a gluten-free diet reduces symptoms for most people.

People following a gluten-free diet must check food labels and avoid the following food and drinks:

  • wheat, durum, emmer, semolina, and spelt
  • barley and barley products, including:
    • malt
    • malt extract
    • malt vinegar
    • brewer’s yeast
  • rye
  • triticale which is a cross between wheat and rye
  • baked goods which contain gluten, such as:
    • cakes
    • biscuits
    • pastry
  • cereals and pasta containing gluten
  • some sauces, syrups, dressings, condiments, and gravies
  • food additives and ingredients that contain gluten, such as:
    • colorings
    • thickeners
    • starches
  • some beers and flavored liquors
  • some processed foods, such as:
    • candy
    • ice cream
    • hot dogs
    • sausages

People must also avoid foods and drinks that may have come into contact with gluten during production. Most food labels will point out a risk.

Gluten may also be present in cosmetics, vitamins, and medications, so a person must check any labels.

Celiac disease can lead to further complications and other conditions if a person does not obtain a diagnosis or treatment from a doctor.

The NIDDK explains that because the disease damages the intestine, it can prevent the body from absorbing essential nutrients. This may further affect other body areas outside the gut causing additional health issues.

The Celiac Disease Foundation (CDF) advises that diagnosing the condition early lowers the chance of developing another autoimmune condition.

For example, if a doctor diagnoses celiac disease in someone between ages 2–4, they have a 10.5% chance of developing another autoimmune condition. However, this increases to 34% if a celiac diagnosis is established after age 20.

Find out about possible at-home testing for celiac disease.

The NIDDK notes that in rare cases, someone may have trouble absorbing nutrients even if they follow a strict gluten-free diet. As a result, their intestine may be severely damaged and unable to heal, a condition called refractory celiac disease.

In this case, a doctor may administer intravenous nutrients and provide specialized treatment.

Possible health conditions

Long-term health conditions that may result from celiac disease include:

Possible autoimmune disorders

Additionally, the CDF explains that not treating celiac disease may lead to other autoimmune disorders. They note that studies suggest that the later the age of diagnosis, the greater the chance of developing another autoimmune disorder.

The foundation lists autoimmune disorders and other conditions associated with celiac disease and their percentage prevalence in celiac disease populations:

  • autoimmune hepatitis: 2%
  • chronic fatigue syndrome: 2%
  • Sjögren’s syndrome: 3%
  • primary biliary cirrhosis: 3%
  • microscopic colitis: 4%
  • idiopathic dilated cardiomyopathy: 5.7 %
  • juvenile idiopathic arthritis: 1.5–6.6%
  • type 1 diabetes: 8–10%
  • liver disease: 10%
  • gluten ataxia: 10–12%
  • peripheral neuropathy: 10–12%
  • unexplained infertility: 12%
  • Down syndrome: 12%
  • anemia: 12–69%
  • lymphocytic colitis: 15–27%
  • autoimmune thyroid disease: 26%

People cannot change the fact that they may be genetically susceptible to celiac disease. However, other environmental factors play a key role in developing the disease, which may be modifiable.

For example, a 2021 study concludes that breastfeeding during the first year of life and the correct timing for introducing gluten may be beneficial.

Additionally, the review notes that further research into manipulating gut bacteria, vaccinating against infections, and altering the immune response may be future strategies to help prevent celiac disease from developing.

Celiac disease can only develop in people who have inherited certain genes. However, only some people who carry the gene variants develop celiac disease.

Scientists are studying additional genes that may trigger the disease and the environmental factors contributing to its development.

People with celiac disease must follow a strict gluten-free diet to prevent symptoms and further damage to their gut. If a doctor does not promptly diagnose or treat celiac disease, it may lead to other health conditions and complications.