Gluten-sensitive Enteropathy Research Articles

Beer consumption patterns are evolving, with gluten-free beers (GFBs) and low- and no-alcohol beers (NABLABs) exhibiting continuous growth, underpinned by health-conscious consumers, younger generations’ preference for moderate drinking, and a rising awareness of gluten intolerance. This study investigates whether online search behaviour reflects these market changes and anticipates future consumption trends. A combined methodological framework was applied, integrating time-series analysis of Google Trends data—based on a decomposition model with a five-year forecast—with descriptive and semantic insights from Search Engine Optimisation (SEO) techniques using the specialised SEOZoom platform. The statistical decomposition enabled the identification of long-term trends, cyclical variations, and seasonal patterns in user interest. Italy was selected as a case study, representing a market where these niche segments have grown considerably despite a traditionally limited craft beer culture. The results reveal a steady rise in online interest in both GFB and NABLAB; GFB searches are primarily linked to health and dietary concerns, whilst NABLAB queries encompass a broader set of topics, including physiology, legislation, and consumption contexts. The forecasts confirm the persistence of this positive trend over the next five years. The approach demonstrates the potential of integrating digital and statistical tools to monitor emerging consumption dynamics and guide strategic decisions in the beverage sector.

BackgroundThe gluten-free diet (GFD) has gained interest in recent years. While evidence showing that the GFD has a positive impact on everybody's health is weak, people with specific gluten-related disorders may benefit from it. As the only available treatment for celiac disease, the GDF can however not be followed without any additional cost.MethodTo measure it, we collected a rich database of gluten-free and gluten-containing products on the Swiss retail market. Using a hedonic pricing method, we disentangled the price of these products and estimated the gluten-free premium.ResultsWe show that gluten-free products are on average 79% more expensive than regular products, which leads to an annual food-budget increase of CHF 421 (approx. the same in USD) (+ 77%) per patient.ConclusionThese results highlight the need to reflect on the social policies accompanying celiac disease in Switzerland, as there is currently no support from the disability or health insurance for these patients.

The increasing use of biodegradable food-contact materials poses a risk for individuals with gluten-related disorders, including celiac disease. Tableware manufactured from wheat or other cereal derivatives may retain gluten proteins; regulations do not mandate allergen labeling. This study evaluated gluten transfer from eight commercial biodegradable items to representative gluten-free foods under realistic conditions. Gluten was quantified in biodegradable tableware and food samples after contact, using monoclonal antibody-based assays (G12 and A1) which detect gluten immunogenic peptides (GIP), providing a sensitive measure of potential immunological risk. Only one wheat-derived dish contained gluten and transferred it into solid and liquid foods. Migration was greater in liquid foods, particularly emulsified systems. In several cases transferred gluten exceeded the 20 mg/kg threshold for gluten-free labeling. Heat and prolonged exposure increased transfer. These findings highlight a critical regulatory gap, underscoring the urgent need for mandatory allergen labeling on biodegradable tableware to protect vulnerable consumers.

Background: Celiac disease (CD) is a gluten-sensitive immune-related enteropathy of the small intestine characterized by villus atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes (IELs). Objectives: To characterize the phenotype of IELs and immune cells of the lamina propria of small intestine control using immuno-oncology and immune-phenotype markers and test the most relevant marker, an immune checkpoint co-inhibitory receptor, leukocyte-associated immunoglobulin-like receptor 1 (LAIR1), in CD. Methods: Immunohistochemical analysis of CD3 (CD3E), CD4, CD8, CD103 (ITGAE), Granzyme B (GZMB), TCR beta (β), TCR delta (δ), CD56 (NCAM), CD16 (FCGR3A), LAIR1 (CD305), PD-L1 (CD274), PD1 (CD279), BTLA (CD272), TOX2, HVEM (TNFRSF14), CD163, HLA-DP-DQ-DR, IL4I1, and FOXP3 was performed using histological analysis. Gene expression analysis was performed using an independent dataset to expand and confirm the findings. Results: IELs exhibited a cytotoxic T-cell phenotype and were CD3+, CD8+, CD103+, TCR beta+, and LAIR1+. The lamina propria (LP) was abundant in CD163+, HLA-DP-DQ-DR+, BTLA+, PD-L1+, CD103+, CD56+, and LAIR1+ cells corresponding to macrophages and T- and B-lymphocytes. In CD, IELs and part of the inflammatory cells of the lamina propria cells were LAIR1+. CD was characterized by higher quantity of LAIR1+ IELs and LP immune cells than the small intestine control (p = 0.004). Higher intestinal lesions evaluated by Marsh scoring were correlated with higher LAIR1 (p < 0.001). Gene expression analysis confirmed the overexpression of the LAIR1 pathway in CD and highlighted BTLA. At the protein level, BTLA overexpression was confirmed in CD. Finally, as a proof-of-concept AI analysis, a convolutional neural network classified LAIR1-stained image patches between the three diagnoses of small intestine control, CD, and reactive tonsils with high accuracy (99.6%). Conclusions: IELs exhibit a cytotoxic T-cell phenotype and were found to be CD3+, CD8+, CD103+, TCR beta+, and LAIR1+ in the small intestine control. Increased numbers of LAIR1+ IELs and lamina propria immune cells characterize CD.

This study aimed to quantify the gluten content in a range of grain flour samples, including wheat, whole wheat, and gluten-free grains, collected from Yemen. Gluten content was determined using a standard wet gluten extraction method, and fiber content was analyzed using the AOAC method. The results showed that the white flour samples had the highest gluten content, ranging from 16.9% to 17.8%. In contrast, whole wheat flour samples had relatively lower gluten content (15.0% to 15.8%), but higher fiber levels. The gluten-free grain flours, such as soya, millet, sorghum, and oats, contained no detectable gluten, making them suitable alternatives for individuals with gluten-related disorders. The study also revealed variations in gluten content between different brands of the same flour type, highlighting the importance of product-specific analysis. These findings provide valuable insights into the dietary implications of gluten-containing and gluten-free foods, which can assist healthcare professionals, food manufacturers, and consumers in making informed decisions.

Challenges in providing adequate nutrition to children with food intolerances: A case study from Pakistan.

This study presents a novel mathematical model to investigate the immune-mediated dynamics of intestinal villi in celiac disease under varying levels of gluten exposure. The model captures the nonlinear interactions between pro-inflammatory (Th1) and regulatory (Th2) T-helper cells and their influence on villous regeneration and destruction. Three gluten scenarios are explored: gluten-free, partial-gluten and gluten-present conditions. Simulations reveal distinct immune outcomes, including full villous recovery in the absence of gluten, progressive atrophy under intermediate exposure and near-complete destruction with sustained gluten intake. Sensitivity analyses across multiple time points identify key regulatory and inflammatory parameters that govern villous behavior. The findings demonstrate how immune polarization — shaped by gluten exposure — drives mucosal outcomes and highlight critical thresholds beyond which immune regulation fails. This framework provides mechanistic insight and a quantitative basis for guiding future therapeutic strategies aimed at restoring immune balance in gluten-related intestinal disorders.

BacillusamyloliquefaciensEG025 was isolated from cheonggukjang, a traditional Korean fermented soybean paste. Among multiple isolates from diverse fermented foods, B.amyloliquefaciens EG025 uniquely exhibited potent gliadin-degrading activity, a trait with the potential to attenuate the immunogenicity of gluten peptides implicated in celiac disease. B.amyloliquefaciensEG025 maintained robust enzymatic activity across a wide pH spectrum (neutral to alkaline) and, remarkably, retained over 90.4% of its maximal activity following a 2-h exposure to pH2. In addition to its gliadin-degrading capability, B.amyloliquefaciens EG025 demonstrated exceptional acid and bile tolerance, indicating a strong capacity to survive and function under the harsh conditions of the human gastrointestinal tract. Whole-genome sequencing and comprehensive annotation revealed biosynthetic gene clusters for secondary metabolites known to confer host benefits, alongside key probiotic functional genes involved in gliadin degradation, acid and bile resistance, stress response, mucosal adhesion, and denovo vitamin biosynthesis. Importantly, safety assessment confirmed the absence of concerning antibiotic resistance determinants or virulence factors, underscoring the strain's safety profile. Phylogenetic reconstruction further highlighted the genetic distinctiveness of EG025 relative to other B.amyloliquefaciens strains, emphasizing its novelty within the species. Collectively, these combined in vitro assay, genomic, and phylogenetic results underscore the significant probiotic potential of B.amyloliquefaciensEG025 and support its future development as a novel therapeutic candidate for improving gluten tolerance and managing celiac disease. Its safety and multifunctional attributes position it as a promising ingredient for functional foods targeted at gluten-sensitive populations.

Peptidases production by Sordariomycetes sp fungus from Manihot esculenta Crantz waste: Application in gluten hydrolysis.

To present the interim results of the work of the specialized Register of gluten-associated disorders, created at the North-West Center for the Treatment of Gluten-Associated Disorders (NWCT GAD) on the basis of the Department of Internal Medicine Propedeutics, Gastroenterology and Dietetics n.a. S.M. Ryss, the Mechnikov North-Western State Medical University. From November 2022 to January 2024, 120 patients were examined on the basis of the NWCT GAD, of which 60 patients met the requirements of the Register and were regarded as patients with gluten intolerance or a genetic predisposition to it. The average age of patients was 35.4 ± 12 years, women predominated - 56.7%. In the structure of nosological forms of GAD, the diagnosis of "celiac disease" was more common (55%). In 23 patients, the primary diagnosis of celiac disease was revised due to the lack of criteria for the disease due to erroneous interpretation of the results and insufficient examination. Gastrointestinal symptoms were observed in 74.2%, extraintestinal manifestations - in 85.5% of patients. Among the patients included in the Register, 31 (51.7%) person had already followed a gluten-free diet for more than 3 months, but in 29 persons various clinical manifestations were observed. There was comorbidity of gluten intolerance with functional diseases of the pancreatobiliary system (41.7%) and chronic gastritis (33.3%). Thus, further work of the Register allows us to obtain new data on the course and prognosis of GAD, improve the diagnostic algorithm for certain forms of gluten intolerance with the formation of an observation plan and a version of the elimination protocol, which will affect the improvement of the quality of medical care and the quality of patients' life.

Gluten-related autoimmunity can cause neurological disease, although the best way to diagnose and monitor such patients is unclear. Serological testing for antibodies against transglutaminase 6 (TG6) has been proposed; however, this is not widely available in clinical practice. Using longitudinal data from patients attending a specialist neurological center with routine TG6 testing, this observational study explores how antibody history relates to brain atrophy, cognition, and quality of life. Serological records of patients with gluten-related neurological disease were collected alongside clinical brain magnetic resonance imaging. Patients were recruited to undertake questionnaires that assessed/included chronic symptom severity, the hospital anxiety and depression scale, the SF-12, and the Biagi scale for gluten-free diet adherence. Volunteers were offered the cerebellar cognitive affective syndrome scale for cognitive testing. Primary analyses focused on patients with ≥5 years of serology (n = 462), and related TG6 history to available clinical outcomes (primary analysis range 89-104). Patients with a previous positive immunoglobulin A (IgA) TG6 result reported greater depression, symptom severity, and poorer physical functioning. IgA TG6 antibody exposure was correlated with regional brain atrophy (age-corrected). Greater self-reported gluten-free diet adherence significantly predicted a recent negative IgA TG6 test. Subgroup analyses replicated multiple findings in patients with and without celiac disease. TG6 testing can identify patients at risk of accelerated brain atrophy, poorer physical functioning, and worsened mental health. IgA TG6 should be used as a diagnostic and monitoring test for patients with relevant neurological presentations, while achieving negative serology with a strict gluten-free diet should be the goal. ANN NEUROL 2025.

BackgroundGluten intolerance is a syndrome characterized by several physical and psychological symptoms such as abdominal pain, constipation, diarrhea, headache, foggy brain, tiredness, anxiety, and depression, related to the ingestion of gluten. Gluten intolerance is one of the gluten-related diseases. It is thought to differ in mechanism from autoimmune diseases such as celiac disease and allergies. Although anti-gliadin IgG antibody has been presented as an immunological marker of gluten intolerance, the diagnostic criteria have not been established yet, and much remains unclear about gluten sensitivity. Hyogo Medical University has the specialized outpatient unit for gluten intolerance since 2019 to conduct medical examinations and research on gluten intolerance. We have already reported the association between treatment-resistant schizophrenia and gluten intolerance may be an aggravating factor in various psychiatric disorders.Aims & ObjectivesWe investigated immunological gluten sensitivity in patients with subjective gluten intolerance who visited our outpatient unit for gluten intolerance and assessed their psychiatric and physical symptoms.MethodFrom 2019 through 2024, patients with subjective symptoms of gluten intolerance aged 20-70 years who visited our outpatient unit for gluten intolerance and age- and sex-matched healthy controls without subjective symptoms of gluten intolerance were recruited. We determined immunological gluten sensitivity using anti-gliadin IgG antibody, and psychiatric and physical symptoms were evaluated by medical interview and self-administered questionnaire. We excluded participants on a strict gluten-free diet because their anti-gliadin IgG antibody levels seem to be reduced. Anti-tissue transglutaminase IgA antibody was also measured to exclude patients with celiac disease. This study was approved by the ethics committee at Hyogo Medical University. Detailed explanations of the study procedures were provided to each participant at the time we received their informed consent.ResultsThe final sample consisted of 73 patients with subjective symptoms of gluten intolerance and 83 healthy controls participated. Among those with subjective symptoms of gluten intolerance, 26 (36%) were determined as immunological gluten sensitivity. Of the healthy controls, 11(13%) were determined as immunological gluten sensitivity. As a marker of gluten intolerance, the sensitivity and specificity of the anti-gliadin IgG antibody were 35.6% and 86.7%.Discussion & ConclusionsThere is a large discrepancy between subjective and immunological gluten sensitivity. Using only anti-gliadin IgG as a biomarker for gluten intolerance may not be sufficient for diagnosis. In order to establish accurate diagnostic criteria for gluten intolerance, we need more precise biomarkers or a combination of several biomarkers including anti-gliadin IgG. We also report psychiatric and somatic symptoms of gluten intolerance and immunological gluten sensitivity.

BackgroundGluten intolerance is a syndrome characterized by several physical and psychological symptoms such as abdominal pain, constipation, diarrhea, headache, foggy brain, tiredness, anxiety, and depression, related to the ingestion of gluten. Gluten intolerance is one of the gluten-related diseases. It is thought to differ in mechanism from autoimmune diseases such as celiac disease and allergies. We have already reported the association between treatment-resistant schizophrenia and gluten intolerance may be an aggravating factor in various psychiatric disorders.Eating disorders are mental disorders that are often difficult to treat, especially when recovering from low weight. Low weight often results in constipation due to reduced gastrointestinal tract activity, but sometimes patients complain of diarrhea despite the absence of laxative abuse. Patients with avoidant/restrictive food intake disorder (ARFID) reduce their intake due to discomfort caused by eating food. Many patients with anorexia nervosa (AN) usually avoid carbohydrates including gluten.Aims & ObjectivesWe hypothesized that gluten sensitivity might be associated with the development of underweight eating disorders and conducted this study.MethodFrom 2020 to 2024, patients with underweight eating disorders who visited our inpatient/outpatient unit in Hyogo medical university hospital and age- and sex-matched healthy controls without subjective symptoms of gluten intolerance were recruited. We determined immunological gluten sensitivity using anti-gliadin IgG antibody, and psychiatric and physical symptoms were evaluated by medical interview and self-administered questionnaire. We excluded participants on a strict gluten-free diet because their anti-gliadin IgG antibody levels seem to be reduced. Anti-tissue transglutaminase IgA antibody was also measured to exclude patients with celiac disease. This study was approved by the ethics committee at Hyogo Medical University. Detailed explanations of the study procedures were provided to each participant at the time we received their informed consent.ResultsThe sample consisted of 34 female patients with underweight eating disorders, including 23 patients with AN, 10 patients ARFID and 1 patient with other specified eating disorder, and 43 healthy controls participated. Immunological gluten sensitivity was significantly higher in underweight eating disorders than in healthy controls, 47%, 11.6%, respectively (P<0.001). Positive rates of immunological gluten sensitivity in each group were 47.3% in AN and 40% in ARFID. Two patients with AN who were positive for anti-gliadin IgG antibodies were introduced to a gluten-free diet during outpatient treatment after immunological gluten sensitivity was detected and showed clear weight gain.Discussion & ConclusionsSignificantly higher immunological gluten sensitivity was found in underweight eating disorders, suggesting that immunological gluten sensitivity may be a factor in the development and maintenance of eating disorders.

Two products fermented with lactic acid bacteria (LAB) were obtained using malted rice (FR) and mashed malted rice (FMR). Peptide, phenolic acids, and γ-aminobutyric acid (GABA) contents and neuroprotective activities were evaluated before and after simulated gastrointestinal digestion. GABA contents of fermented products were 45 and 51 mg 100 g−1, with a bioaccessibility of 51 and 45% for FR and FMR, respectively. Both fermented malted rice products exhibited inhibitory effects against tyrosinase, acetylcholinesterase, and prolyl oligopeptidase, with FR demonstrating the highest inhibitory activity. The neuroprotective properties were increased after digestion and could potentially be attributed to bioactive peptides generated by germination, fermentation, and digestion, as well as free phenolic acids. These findings suggest that fermented malted rice possesses promising biofunctional properties and may serve as suitable dietary options for individuals with gluten and lactose intolerance, offering additional neuroprotective benefits.

The self-assembly of endogenous and exogenous peptides into proteolysis-resistant oligomers can trigger toxic cellular events and diseases. In Alzheimer's disease (AD), the structural polymorphisms of endogenous amyloid-β (Aβ) 1-40 and 1-42 aggregates are essential for their neurotoxic effects. Recent findings on structural differences between brain-derived and in vitro fibrils underscore the need to improve the molecular and supramolecular models of diseases, for example, by stabilizing monomer conformations that lead to disease-relevant structures. In gluten-related disorders (GRDs), particularly celiac disease (CeD), research focuses on exogenous proteolytically resistant gliadin peptides (PRGPs) such as the 33-mer, p31-43, and pepsin-trypsin-derived gliadin peptides. Notably, these PRGPs form nanostructures, which may explain their behavior as nonreplicating pathogens. Thus, understanding their self-assembly has recently gained attention. This review invites both newcomers and experts in the field to tackle the challenges of characterizing peptide self-assembly process as first step to develop successful therapeutic interventions. For AD researchers, it highlights protocols for obtaining monomers and their supramolecular characterization to uncover mechanisms of brain-derived fibril formation, while also showcasing opportunities to explore PRGP nanostructures. For GRD researchers, it offers protocols to obtain PRGP nanostructures and their thorough characterization prior to cellular studies, inspired by approaches in AD research. This review contributes to interdisciplinary efforts toward therapeutic strategies grounded in molecular and supramolecular data by outlining structural insights, characterization protocols, and existing knowledge gaps. Its final aim is to connect established and emerging research domains related to Aβ and gliadin peptides that may have potential applications in peptide self-assembly and the gut-brain axis research, respectively.

This study aims to develop a gluten-free wet noodle product by utilizing a combination of tapioca flour and rice flour, as well as the addition of purple sweet potato flour as a natural source of anthocyanin and dietary fiber. This innovation is expected to provide an alternative functional food for consumers with gluten intolerance while increasing the nutritional value of noodle products. Three formulation variations were tested, namely with the addition of purple sweet potato flour of 100 g, 125 g, and 150 g, while the amount of tapioca and rice flour was maintained at 100 g each, and the addition of 225 mL of water and 4 g of salt. Organoleptic quality assessment was carried out by 35 panelists using parameters of color, shape, aroma, texture, and taste, which were then analyzed using one-way analysis of variance (ANOVA) and Duncan's follow-up test to determine significant differences between treatments. The results showed that the best formulation was obtained from a combination of 100 g tapioca, 100 g rice flour, and 150 g purple sweet potato flour. The resulting noodle product has an attractive dark purple color, a fairly straight and long shape (&gt;30 cm), a distinctive purple sweet potato aroma, a fairly chewy and elastic texture, and a savory taste with purple sweet potato nuances. Laboratory tests on the best samples showed prominent nutritional content, namely 59.81% carbohydrates, 3.88% dietary fiber, 6.82% protein, 31.90 mg anthocyanin/100 g, 3.71% fat, 24.50% water content, and 0.21% ash. With these organoleptic characteristics and nutritional composition, this gluten-free wet noodle product has the potential to be a healthy and functional alternative food, especially for individuals who require a gluten-free diet. This research also opens up opportunities for the development of noodle products based on local ingredients that are highly nutritious and have a selling value.

This study examines the key factors influencing consumer purchase intentions for free-from gastronomic products, focusing on the roles of perceived benefits, perceived barriers, and perceived susceptibility. The study applies the Health Belief Model (HBM) to explore how perceived susceptibility mediates the effect of perceived benefits on purchase intentions, while perceived barriers moderate this relationship. A quantitative research approach was adopted, utilizing a cross-sectional survey of 386 health-conscious consumers. Data were analyzed using Structural Equation Modeling (SEM) to test the direct, indirect (mediation), and interaction (moderation) effects. The results reveal that perceived benefits alone do not significantly influence purchase intentions; however, this relationship becomes significant when mediated by perceived susceptibility. Consumers who perceive themselves as at risk of diet-related health issues (e.g., diabetes, gluten intolerance) are more likely to purchase free-from products. Perceived barriers significantly moderate this relationship, such that consumers with higher perceived barriers (e.g., concerns about taste, price, and availability) are less likely to translate perceived benefits into purchase behavior. This study extends the HBM by demonstrating that perceived susceptibility plays a crucial mediating role in consumer food choices, particularly in the context of health-conscious purchasing behaviors. It also highlights the importance of barrier-reduction strategies in promoting free-from products. Marketers should emphasize health risk reduction messaging to increase perceived susceptibility, while simultaneously addressing price, taste, and availability concerns to mitigate perceived barriers. Strategies such as flavor innovations, affordability measures, and expanded distribution can enhance consumer adoption of free-from products. This study integrates HBM constructs into consumer behavior research, offering a novel approach to understanding psychological drivers of free-from product consumption. The findings provide practical recommendations for businesses and policymakers seeking to promote health-oriented food choices.

ABSTRACTIncreased knowledge about celiac disease and health concerns has generated increased demand for nutritious gluten‐free snacks; however, most extruded gluten‐free foods remain low in protein and fiber. This study aimed to develop gluten‐free extruded snacks with improved nutritional and functional properties using lentil flour (LF) and to investigate the impact of extrusion conditions on the properties of extruded snacks. Extruded snacks were produced using a corotating twin‐screw extruder with different ratios of LF to corn grits (CG) (0:75, 25:50, 50:25, and 75:0), with fixed amounts of tomato powder, potato flour, and carrot pomace powder. Two feed moisture (FM) levels (16% and 18%) and three barrel temperatures (BT) (135°C, 150°C, and 165°C) were also investigated. The pasting properties of the flour blends and functional, morphological, sensory, and physicochemical characteristics of the extrudates were assessed. The variation in pasting properties of blends was significant; higher CG content increased paste temperature from 67.0°C to 76.6°C, while LF addition reduced it. Increasing LF and FM negatively influenced the expansion ratio (ER) (3.55–1.55) whereas positively affected apparent density (AD) (0.43–2.63 g/cm3). BT had the opposite effect on AD, with higher BT leading to reduced density. LF and FM significantly affected the texture properties; the hardness increased from 86.72 N to 399.63 N, and the crispness decreased with increasing LF and FM. LF addition increased the a* value, whereas higher BT reduced redness. Additionally, LF exhibited the highest water solubility index (32.53%), while CG had the highest water absorption index (5.39 g/100 g). SEM analysis revealed denser and less expanded formations at higher LF levels. These findings suggest that lentil flour can improve the nutritional and functional properties of gluten‐free extruded snacks when the extrusion conditions are adequately controlled. This could offer a viable option for health‐conscious consumers and those with gluten intolerance.

Gluten-related disorders, including celiac disease (CeD) and non-celiac gluten sensitivity (NCGS), are triggered by the immune response to gluten peptides that resist complete digestion by human gastrointestinal enzymes. Microbial peptidases have emerged as promising biocatalysts capable of degrading these immunogenic peptides, offering potential therapeutic and industrial applications. This review explores the role of microbial peptidases in gluten degradation, highlighting key enzyme families, their mechanisms of action, and their effectiveness in reducing gluten immunogenicity. Additionally, we discuss advances in enzymatic therapy, food processing applications, and the challenges associated with optimizing microbial enzymes for safe and efficient gluten detoxification. Understanding the potential of microbial peptidases in mitigating gluten-related disorders paves the way for novel dietary and therapeutic strategies.

Celiac disease, also known as gluten-sensitive enteropathy, is an immune-mediated disorder with a broad clinical manifestations including psychiatric symptoms. The present study aims to evaluate body image dissatisfaction, depression, and anxiety among adolescents with celiac disease and to draw attention to the diagnosis and management of these comorbidities. This study was performed in Pediatric Gastroenterology unit of Erciyes University between July 2022 and June 2023. Adolescents aged 12-18 years diagnosed with histopathologically confirmed celiac disease and their age- and sex-matched healthy peers, were recruited in the study. A significant difference was found between the patient and control groups in depression (p < 0.001), and body image dissatisfaction (p < 0.001). Adolescents who were non-compliant with the diet showed significantly elevated risk of body image dissatisfaction and depression compared with participants who adhered to the strict diet (p = 0.001, p < 0.001, respectively). A positive correlation was observed between tTGA-IgA antibody levels and depression (r = 0.618; p < 0.01), and a negative correlation was found between tTGA-IgA antibody levels and body image dissatisfaction scores (r = -0.400, p = 0.014). The present results underscore adolescents with celiac disease are at an heightened risk for psychiatric burden. Therefore, periodic follow-up should be performed to determine body image satisfaction in adolescents with celiac disease and to recognize mood-related symptoms. Early identification of symptoms associated with mood disorders and body image dissatisfaction in adolescents is critical for efficient patient care within celiac disease and to enhance adolescents' holistic well-being.