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Coeliac Disease

Coeliac disease is a common digestive condition where the small intestine becomes inflamed and unable to absorb nutrients.

It can cause a range of symptoms including diarrhoea, abdominal pain and bloating.

Coeliac disease is caused by an adverse reaction to gluten, a dietary protein found in three types of cereal:

  • wheat
  • barley
  • rye

Gluten is found in any food that contains the above cereals, including:

  • pasta
  • cakes
  • breakfast cereals
  • most types of bread
  • certain types of sauces
  • some types of ready meals

In addition, most beers are made from barley.

Symptoms of coeliac disease

Eating foods containing gluten can trigger a range of gut-related symptoms, such as:

  • diarrhoea, which may smell particularly unpleasant
  • abdominal pain
  • bloating and flatulence (passing wind)
  • indigestion
  • constipation

Coeliac disease can also cause a number of more general symptoms, including:

  • fatigue as a result of malnutrition (not getting enough nutrients from food)
  • unexpected weight loss
  • an itchy rash (dermatitis herpetiformis)
  • problems getting pregnant
  • nerve damage (peripheral neuropathy)
  • disorders that affect co-ordination, balance and speech (ataxia)

What causes coeliac disease?

Coeliac disease is an autoimmune condition. This is where the immune system – the body’s defence against infection – mistakenly attacks healthy tissue.

In coeliac disease, the immune system mistakes substances found inside gluten as a threat to the body and attacks them.

This damages the surface of the small bowel (intestines), disrupting the body’s ability to absorb nutrients from food.

It’s not entirely clear what causes the immune system to act in this way, but a combination of genetics and the environment appear to play a part.

Coeliac disease isn’t an allergy or an intolerance to gluten.

 

Treating coeliac disease

There’s no cure for coeliac disease, but switching to a gluten-free diet should help control symptoms and prevent the long-term consequences of the condition.

Even if you have non-existent or mild symptoms, changing your diet is still recommended because continuing to eat gluten can lead to serious complications.

It’s important to ensure that your gluten-free diet is healthy and balanced. An increase in the range of available gluten-free foods in recent years has made it possible to eat both a healthy and varied gluten-free diet.

 

Complications of coeliac disease

Complications of coeliac disease only tend to affect people who continue to eat gluten, or those who’ve yet to be diagnosed with the condition, which can be a common problem in milder cases.

Potential long-term complications include:

  • osteoporosis (weakening of the bones)
  • iron deficiency anaemia
  • vitamin B12 and folate deficiency anaemia

Less common and more serious complications include those affecting pregnancy, such as having a low-birth weight baby, and some types of cancers, such as bowel cancer.

 

Who’s affected

Coeliac disease is a common condition that affects approximately one in every 100 people.

However, some experts think this may be an underestimate because milder cases may go undiagnosed or be misdiagnosed as other digestive conditions, such as irritable bowel syndrome (IBS).

Reported cases of coeliac disease are two to three times higher in women than men. It can develop at any age, although symptoms are most likely to develop:

  • during early childhood – between eight and 12 months old, although it may take several years before a correct diagnosis is made
  • in later adulthood – between 40 and 60 years of age

 

Diagnosing coeliac disease

Routine testing for coeliac disease is very rarely carried out around the world.

Testing is usually only recommended for people at an increased risk of developing coeliac disease, such as those with a family history of the condition.

First-degree relatives of people with coeliac disease should be tested.