A Brief Guide To Coeliac Disease

Coeliac disease (pronounced see-lee-ak) is a common gut disease which is treated entirely via diet through a registered dietitian.

If you hadn’t heard of it before then you might be surprised to hear that it affects 1 in 100 of us – probably more, as its thought that lots of us are walking around yet to be diagnosed.

Treatment of Coeliac Disease is complete, live-long avoidance of wheat, rye and barley – or rather the protein called gluten that they contain.  It’s not classed as an allergy or intolerance, but rather an autoimmune condition whereby eating gluten causes the lining of the small intestine to become damaged.   This damage often causes diarrhoea, anaemia, weight loss, or poor growth and gut problems, but in some people, the gut damage is there, but the only symptoms they have are a general feeling of low energy, headaches or even skin problems.

Coeliac Disease is often diagnosed in childhood, but many people are now being diagnosed in their 40s and older. Diagnosis involves an initial blood test for the antibodies known as ‘IgA tissue transglutaminase’ or ‘endomysial IgA’.  If those tests come back positive, your doctor refers you to a gastroenterology specialist who will take a biopsy from your gut to confirm the diagnosis.    To get a reliable picture you need to have been eating gluten-containing foods every day for 6 weeks.  The self-testing kits available now in chemists are possible as reliable as the blood tests, but don’t give the detailed results that your GP will accept.

If you suspect you might have Coeliac – it’s worth asking your GP to test you – if left undiagnosed, the gut damage caused by eating gluten can cause osteoporosis (weakening of the bones), anaemia and the associated tiredness, growth defects, infertility, and (rarely) some types of cancer.  The good news is that avoidance of gluten-containing foods such as normal biscuits, cakes, breads, pasta, and cereals causes the gut to completely recover.  Fruit, vegetables, rice, potatoes, meat, fish, dairy products, beans and pulses are all naturally gluten-free, and there are many gluten-free biscuits, breads, pastas and cereals available too, so a healthy and enjoyable diet is absolutely achievable.

Do you suspect you might have Coeliac?  Ask your GP to test you if you have any of the following (list taken from the National Institute of Clinical Excellence guidance – link below).

  • a close family member – parent, child or sibling – with Coeliac Disease
  • chronic or intermittent diarrhoea
  • failure to thrive or faltering growth (in children)
  • persistent or unexplained gastrointestinal symptoms including nausea and vomiting
  • prolonged fatigue (‘tired all the time’)
  • recurrent abdominal pain, cramping or distension
  • sudden or unexpected weight loss
  • unexplained iron-deficiency anaemia, or other unspecified anaemia
  • autoimmune thyroid disease
  • dermatitis herpetiformis
  • irritable bowel syndrome
  • type 1 diabetes
  • Addison’s disease
  • amenorrhoea (lack of periods)
  • aphthous stomatitis (mouth ulcers)
  • autoimmune liver conditions
  • autoimmune myocarditis
  • chronic thrombocytopenia purpura
  • dental enamel defects
  • depression or bipolar disorder
  • Down’s syndrome
  • epilepsy
  • low-trauma fracture
  • lymphoma
  • metabolic bone disease (such as rickets or osteomalacia)
  • microscopic colitis
  • persistent or unexplained constipation
  • persistently raised liver enzymes with unknown cause
  • polyneuropathy
  • recurrent miscarriage
  • reduced bone mineral density
  • sarcoidosis
  • Sjögren’s syndrome
  • Turner syndrome
  • unexplained alopecia
  • unexplained subfertility

If you do get diagnosed, you should be referred to see a dietitian, who will then be able to give you plenty of advice on enjoying a varied and satisfying gluten-free diet, and, once you feel the difference in your health, you will be happy to keep it up.

Useful links:

Coeliac UK – the fantastic support charity for sufferers

NHS Choices guide to Coeliac Disease

NICE guidance for Coeliac Disease, published 2009

British Society of guidance on Coeliac Disease, published 2005

Do you have Coeliac disease – share your story of how you were diagnosed below:

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