Coeliac disease is a digestive condition which occurs when a person has heightened sensitivity to gluten, a protein contained in wheat and similar types of cereal. The majority of people tolerate gluten very well, but people with Coeliac disease develop unpleasant symptoms if they eat food that contains gluten. This can result in harm to the small intestine lining.
It is a type of auto-immune disease, which means that the body’s immune system starts to attack itself when it is exposed to gluten. This results in harm to the small intestine and can result in difficulties with absorption, which prevents the body from getting all the nutrients, vitamins and minerals it needs to function properly.
What causes Coeliac disease?
Coeliac disease occurs when the body mistakes gluten for a threat and starts to attack itself. It is not known why this reaction occurs, but experts believe a combination of genetic and environmental factors play a role. There is some evidence to suggest Coeliac disease runs in families. If you have a close relative with Coeliac disease, you are ten times more likely to develop the condition than somebody without a relative with the condition – however, this still only represents an increase of 10%. Research also shows that Coeliac disease is associated with genetic mutations affecting a group of genes known as the HLA-DQ genes. Environmental factors which may increase the risk of Coeliac disease include digestive infections (such as a rotavirus infection, which is common in childhood) and some experts believe that introducing gluten into the diet before the age of six months can increase the risk of Coeliac disease.
How is Coeliac disease diagnosed?
If you experience symptoms or feel unwell you should visit your GP, who will ask you about relevant symptoms and your medical history. If they suspect you have Coeliac disease, they will carry out further tests, including a blood test and a gut biopsy (this will be done in hospital). The blood test will be analysed to check for the presence of antibodies. These are produced by the immune system to fight off infections and viruses, but in people with Coeliac disease the body produces antibodies to fight gluten because it mistakes it for a threat. If Coeliac disease is confirmed further tests may be carried out to check that your body is absorbing nutrients properly, as Coeliac disease can damage the small intestine lining and affect absorption. Your iron levels may also be checked to determine whether you have anaemia.
How common is Coeliac disease?
In recent years, it has grown to be evident that Coeliac disease is a relatively common condition. During the 1980’s improvements were made in the testing process and more people have been diagnosed with the disease over the course of the last two decades. Coeliac disease can be diagnosed in people of all ages, but it is most commonly diagnosed during childhood or teenage years. Coeliac disease is more common in some countries than others and it tends to affect women more than men. Recent figures show that one in one hundred people in the UK are affected by Coeliac disease, but the figures may be higher than this because many people are unaware they have the condition. This is because the condition can sometimes cause only mild symptoms.
Symptoms of Coeliac disease
Coeliac disease can affect people in different ways, with some experiencing only mild symptoms and others feeling very ill if they are exposed to gluten. In some cases, the symptoms are so mild that people do not even realise there is anything wrong with them. In children, common symptoms include diarrhoea, problems gaining weight and vomiting. Common symptoms among adults include:
- Abdominal pain.
- Weight loss.
- Anaemia (which cause tiredness and a lack of energy and motivation).
- Tingling and pins and needles (known as neuropathy).
- Stomach cramps.
- Muscle spasms.
In some cases, Coeliac disease is diagnosed based on symptoms that do not affect the digestive system, including weak bones and anaemia. These conditions are caused by problems with absorption and indicate that the lining of the small intestine is damaged. It is important that Coeliac disease is diagnosed as early as possible to prevent this extent of damage.
Treatment for Coeliac disease
The most effective treatment for Coeliac disease is to avoid gluten. This can be difficult at first as many common foods contain gluten, but most people find that they get used to it quickly. The range of gluten-free foods available from supermarkets and restaurants has increased considerably in recent years. If you are diagnosed with Coeliac disease, information and advice will be provided by a nutritionist, so that you know which foods you should and shouldn’t be eating. Most people find that their symptoms improve rapidly once they begin their gluten-free diet.