What is Coeliac Disease?
Coeliac disease is a condition in which the immune system responds abnormally to dietary gluten. Gluten is a protein that can be found in wheat, rye, barley, and oats. In people with Coeliac disease, eating foods containing gluten can cause damage to the lining of the small intestine.
How common is Coeliac Disease?
Coeliac disease affects approximately 1% of the population and may develop at any stage in life. Coeliac disease is underdiagnosed in the community.
Who gets Coeliac Disease?
People are born with a genetic predisposition to Coeliac disease. However, not everyone with the genes will develop Coeliac disease. A first degree relative of someone with coeliac disease has a 10% chance of also having the condition. Environment is also an important factor. Coeliac disease is more common in Caucasians and people from the Middle East. It is uncommon in Asians.
How is Coeliac Disease diagnosed?
The initial screening investigation for Coeliac disease is through blood tests. However, the definitive test is small bowel (duodenal) biopsies obtained at Gastroscopy. This will allow confirmation of damage to the small bowel lining. It is important that these investigations are NOT performed whilst on a gluten free diet.
What are the symptoms of Coeliac Disease?
The symptoms of Coeliac disease vary considerably. Some people with Coeliac disease do not have any symptoms. Symptoms may include lethargy, abdominal discomfort, diarrhoea and/or constipation, bloating, nausea/vomiting and weight loss. It is important to also remember that Coeliac disease may have other manifestations such as abnormal liver function tests, recurrent miscarriages, and rashes. In children, Coeliac disease may present as delayed growth or development.
What other conditions may be associated with Coeliac Disease?
Coeliac disease may be associated with other “autoimmune” conditions such as thyroid disease, type 1 diabetes and rheumatoid arthritis. Coeliac disease may also contribute to the development of anaemia (low blood count), micronutrient deficiencies (e.g. iron, folate, B12, calcium, vitamin D) and osteoporosis (thinning of bones).
What is the treatment for Coeliac Disease?
The best treatment for Coeliac disease is a strict lifelong gluten free diet. This should only be commenced once the diagnosis is made. A referral to a specialist dietician is recommended.
Supplements may also be required to correct any micronutrient deficiencies. Bone mineral density may be performed to investigate for osteoporosis.