Coeliac disease is an autoimmune condition caused by the reaction of our immune system against gluten which is a protein found in wheat, barley and rye. When people with Coeliac disease eat gluten, their immune system reacts by damaging the lining of the small intestine. We think that is it quite a common condition with about 1 in 100 people in the UK having the condition. However, most people with Coeliac disease don’t know that they have if as they may have very mild and non-specific symptoms.
The symptoms of Coeliac disease range from mild to severe and include:
- Bloating and abdominal cramp
- Diarrhoea or Constipation
- Tiredness and fatigue
- Mouth ulcers
- Weight loss
- Anaemia or lack of iron, vitamin B12 and folic acid
Some of the symptoms of Coeliac disease may be mistaken as irritable bowel syndrome or wheat intolerance, and occasionally may be put down to stress or getting older.
How is Coeliac Disease diagnosed?
After a careful history and examination, you will have a blood test – this looks for antibodies in your blood which would indicate Coeliac disease – it is very important that if you suspect that you have Coeliac disease, that you do not start removing gluten from your diet until after all the tests have been performed – removing gluten could interfere with the test results.
If the blood test is negative, it is very unlikely that you have Coeliac. If the blood test is positive, you will need a further test called a gastroscopy. At the time of a gastroscopy, a biopsy (specimen) is taken from the lining of your small bowel, which helps to confirm the diagnosis of Coeliac disease. Again, it is important to continue to eat gluten containing food until after the gastroscopy.
Treatment of Coeliac Disease
As the disease is caused by eating gluten, the treatment is therefore to avoid eating any food which contains it – that is, following a life-long gluten-free diet. To help with a gluten free diet, you will usually see a dietician to help you gain knowledge about which foods contain gluten and how to maintain a balanced diet without wheat and other cereals that you will need to avoid.