What is Coeliac Disease? Coeliac Disease can often be confused with IBS, IBD, allergy, or intolerance. Although symptoms may be similar, it is an autoimmune condition triggered by consuming gluten. Gluten is a protein found in wheat, barley and rye. Coeliac UK suggests that as many as 1 in 100 people have Coeliac Disease. Yet, only a third of people receive a diagnosis. Possibly because some people with CD may be asymptomatic and many people aren’t familiar with the symptoms. Although it can present at any age, it is most commonly diagnosed later, at 40-60 years old. It is also most prevalent in people with an autoimmune condition (e.g., Type 1 diabetes) and who have a first-degree relative with coeliac disease.

Symptoms

Symptoms may include diarrhoea, constipation, abdominal pain, bloating, or excessive wind. Faltering growth in children, fatigue, iron deficiency anaemia, nausea or vomiting, weight loss, recurrent mouth ulcers or a skin rash (dermatitis herpetiformis). Some people also suffer from unexplained subfertility, repeated miscarriages, or unexplained neurological problems, which may lead to their diagnosis of CD.

If someone with Coeliac Disease consumes gluten, the body falsely thinks gluten is a pathogen. It triggers the autoimmune response to flatten or damage the lining of the small intestine. This is an issue because these villi (hair-like follicles) in the lining play a vital role in allowing us to absorb the nutrients from the food we eat. As it is an autoimmune condition, even a crumb of gluten-containing bread, for example, can trigger an immune response even if the person doesn’t suffer from any physical symptoms. After some time maintaining a strict gluten-free diet, the lining of the small intestine eventually heals. Nutrients can be reabsorbed once again and the risk of complications also reduces. Therefore, it is crucial that a strict lifelong gluten-free diet. Education from a dietitian is essential to be able to maintain these changes.

Testing

If you think you may have CD it is important to get tested. If left untreated, there is an increased risk of complications such as anaemia or osteoporosis.

In the past, the only way to diagnose CD was to have an endoscopy to take a biopsy of the small intestine. Now the first-line test is a simple IgG and IgA antibody blood test. It is essential to continue to consume gluten for the tests to be valid. Depending on the results and personal and family history of CD or other autoimmune conditions, the doctor may request additional supporting tests.

Coeliac UK has created a free online self-assessment that you can take to give you an idea if you may have any of the common symptoms https://isitcoeliacdisease.org.uk . It is always best to speak to your GP about any concerns. Taking the completed assessment with you during your consultation may be helpful.

For more information about Coeliac Disease have a look at :

• https://www.bda.uk.com/resource/coeliac-disease-and-gluten-free-diet.html

• https://www.coeliac.org.uk/home/

• https://www.nhs.uk/conditions/coeliac-disease/