What is coeliac disease?

Coeliac disease is similar to wheat allergies in that both react to gliadin. In wheat allergy, gliadin binds to the IgE anti-gliadin antibody, which triggers mast cells to release histamine and other chemicals, leading to the signs and symptoms of an allergic reaction. In coeliac disease, it is IgG and IgA anti-gliadin antibodies that are involved. These also react to alpha, beta, and gamma gliadins, rather than omega gliadins.

In coeliac disease, the immune system causes changes in the absorptive surface of the gut. The gut wall is lined by many finger-like projections called villi. After exposure to gluten, the immune system causes these villi to shrink, and thus the absorptive surface of the gut is greatly reduced, leading to malabsorption.

Signs and symptoms include diarrhoea, bloating, gas, fatigue, and failure to put on weight and failure to thrive in infants and children. You can also develop deficiency diseases because you cannot absorb any nutrients. These include anaemia (from not absorbing enough iron), bone problems such as rickets in children and osteomalacia in adults (from not absorbing calcium or vitamin D). Bacteria which line the gut thrive on the food which we do not absorb, and can proliferate and worsen symptoms.

The management for coeliac disease is a lifelong gluten-free diet.

Refractory coeliac disease is a condition where a gluten-free diet does not alleviate symptoms. This might be because the gut wall has been damaged too much, or it might be because immune cells are still stimulated. In such cases, your doctor might need to give you steroids to reduce the action of your immune system.

Wheat Allergies Treatment Guide Index:

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