Digestive Health Celiac Disease What Is Silent Celiac Disease? By Jane Anderson Jane Anderson Facebook Twitter Jane Anderson is a medical journalist and an expert in celiac disease, gluten sensitivity, and the gluten-free diet. Learn about our editorial process Updated on October 20, 2020 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Robert Burakoff, MD, MPH Medically reviewed by Robert Burakoff, MD, MPH LinkedIn Robert Burakoff, MD, MPH, is board-certified in gastroentrology. He is the vice chair for ambulatory services for the department of medicine at Weill Cornell Medical College in New York. Learn about our Medical Expert Board Print If you have celiac disease, you probably know it means your body reacts to the gluten protein found in the grains wheat, barley, and rye by attacking the lining of your small intestine. In some people with the condition, this results in major gastrointestinal symptoms, including diarrhea, constipation, and abdominal pain. But other people with celiac disease don't notice major digestive symptoms. They may have other symptoms of celiac disease, including fatigue and neurological issues... or they may have no symptoms at all. if you have celiac disease without noticeable symptoms, your condition is called "silent celiac disease" or "asymptomatic celiac disease." While silent celiac disease may be entirely without symptoms, villous atrophy (the damage of the finger-like lining of the intestines) may still occur, foreshadowing the eventual development of overt and potentially severe intestinal injury. Laura Porter / Verywell How Silent Celiac Is Revealed These days, with awareness of celiac disease growing, many more people are being diagnosed as celiac simply because they're identified through screening, not because they had symptoms. When someone in your family is diagnosed with celiac, medical recommendations call for screening all close relatives. This screening can pick up cases of asymptomatic celiac disease. Other people are diagnosed with celiac disease because they have a related condition, such as thyroid disease or anemia, and their physicians refer them for celiac screening. In many of these people, the diagnosis comes as a surprise (or even a shock); if you don't have digestive symptoms, you're probably pretty stunned to discover you actually have a serious condition involving your digestive tract. Challenges of a Gluten-Free Diet It can be tough to go and stay gluten-free if you don't notice symptoms from your condition. There's no doubt that eating gluten-free can be complicated and difficult, and cheating on the gluten-free diet is pretty tempting if you don't suffer from symptoms. However, there are two reasons to stay gluten-free even if you don't notice major symptoms from gluten ingestion. The first is to safeguard your long-term health. Cheating on the diet may contribute to some pretty significant health problems, including malnutrition, infertility, osteoporosis and potentially even certain cancers. Even cheating on your diet once or twice a month can prevent your intestines from healing and may perpetuate the abnormal immune response that causes the disease, essentially wiping out the benefits of gluten-free eating. In addition, many people with celiac disease, including silent or asymptomatic celiac disease, may develop other autoimmune diseases, such as rheumatoid arthritis and psoriasis, if they continue to consume gluten. While there's little research on this, some studies suggest that a gluten-free diet might prevent or help treat these conditions. Benefits of a Gluten-Free Diet The second reason to stay gluten-free, even if you don't notice major symptoms from gluten ingestion, is that you might actually feel better. As a so-called "silent celiac," you shouldn't assume that you won't notice improved health once you adopt a strict gluten-free diet. In fact, recent research indicates the opposite: People with silent celiac disease who follow the gluten-free diet actually do report improved health. Studies suggest that people with silent celiac disease tend to normalize low-grade symptoms and only recognize them once they are improved by a gluten-free diet. In a study reported at the 2011 Digestive Diseases Week conference, a Finnish research team looked at 40 subjects who had no digestive symptoms but who tested positive for celiac disease on a very specific celiac disease blood test. All also had some intestinal damage. The researchers split the group in two, assigning half of the patients to a gluten-free diet and the other half to a regular, gluten-containing diet. They then tracked them for a year through surveys designed to evaluate both gastrointestinal symptoms and health-related quality of life. What the Study Found The study found that survey scores—both in symptoms and quality of life—improved in the group following the gluten-free diet, while scores stayed the same in the group on the regular diet. In addition, levels of folic acid and vitamin B12 improved in the gluten-free group but stayed the same in the regular diet group. Even though the group following the gluten-free diet hadn't noticed symptoms before, they reported seeing some minor symptoms—including reflux, bloating, abdominal distention, and flatulence—clear up when eating gluten-free. The researchers also performed repeat biopsies in both groups and noted improvements in intestinal damage in the group eating gluten-free. After one year of the study, the researchers switched the gluten-eating group to the gluten-free diet. Once everyone in the study had eaten gluten-free for a full year, they polled the study subjects. The results? A full 85 percent said they'd continue eating gluten-free, and 58% viewed their celiac screening and subsequent diagnosis as "positive" or even "very positive." A Word From Verywell Even if you're a true silent celiac and have no real symptoms, especially gastrointestinal symptoms, you may still notice health benefits, and maybe even see a few minor complaints clear up, after going gluten-free. In addition, you may possibly save yourself from additional health problems down the road by sticking to the gluten-free diet. With Refractory Celiac Disease, a Gluten-Free Diet Doesn't Work Was this page helpful? Thanks for your feedback! Following a gluten-free diet can be challenging. We're here to help. Sign up and receive our free recipe guide for delicious gluten-free meals! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 8 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Caio G, Volta U, Sapone A, et al. Celiac disease: a comprehensive current review. BMC Med. 2019;17(1):142. doi:10.1186/s12916-019-1380-z Parzanese I, Qehajaj D, Patrinicola F, et al. Celiac disease: from pathophysiology to treatment. World J Gastrointest Pathophysiol. 2017;8(2):27-38. doi:10.4291/wjgp.v8.i2.27 Popp A, Kivelä L, Fuchs V, Kurppa K. Diagnosing celiac disease: towards wide-scale screening and serology-based criteria?. Gastroenterol Res Pract. 2019. doi:10.1155/2019/2916024 Freeman HJ. Celiac-associated pancreatic disease. Ann Gastroenterol. 2016;29(3):241-2. doi:10.20524/aog.2016.0048 Tersigni C, Castellani R, De waure C, et al. Celiac disease and reproductive disorders: meta-analysis of epidemiologic associations and potential pathogenic mechanisms. Hum Reprod Update. 2014;20(4):582-93. doi:10.1093/humupd/dmu007 Ungprasert P, Wijarnpreecha K, Kittanamongkolchai W. Psoriasis and risk of celiac disease: a systematic review and meta-analysis. Indian J Dermatol. 2017;62(1):41-46. doi:10.4103/0019-5154.198031 Rubio-tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108(5):656-76. doi:10.1038/ajg.2013.79 Kurppa K, Collin P, Lindfors K, et al. Should screen-detected and asymptomatic celiac disease patients be treated? A prospective and randomized trial. Gastroenterology. 2011;140(5). doi:10.1016/s0016-5085(11)60454-x Additional Reading A. Tursi et al. Prevalence of celiac disease and symptoms in relatives of patients with celiac disease. European Review for Medical and Pharmacological Sciences. 2010 June; 14(6): 567-72.