Coeliac disease is an autoimmune condition that is caused by an adverse reaction to gluten, found in wheat, barley and rye. In most of Europe this affects approximately one in every 100 people, with rates varying in other regions. Coeliac disease results in damage to the lining of the gut, which affects the body’s ability to absorb nutrients from food. This has long term consequences for many aspect of health.
If you have coeliac disease and eat gluten, you may experience a range of unpleasant symptoms including:
- Varying degrees of diarrhoea and flatulence
- Nausea, vomiting, pain, cramping and bloating
- Iron, vitamin B12 and folic acid deficiency
- Chronic fatigue, lethargy and anaemia
- Weight loss
- Mouth ulcers and skin rashes
- Neurological problems including loss of co-ordination and numbness in the hands and feet
It is easy to confuse the symptoms of coeliac disease with other less serious conditions such as irritable bowel syndrome or wheat intolerance. Experts believe one in four people with the disease are misdiagnosed as having irritable bowel syndrome (IBS). Seeing a specialist, who can correctly diagnose the cause of your symptoms, is the first step.
Coeliac disease is an autoimmune condition, which means that the immune system reacts to gluten and begins attacking the gut itself. Even tiny amounts of gluten can be damaging and the only way to feel better is to remove gluten from the diet completely, which allows the gut to heal.
Over time, a failure to diagnose and treat coeliac disease can lead to serious complications, such as nutritional deficiencies, osteoporosis, neurological problems and rarely lymphoma, a type of cancer. Yet, it takes people an average of 13 years to get a diagnosis, and longer in some cases. If you have symptoms that indicate you may have coeliac disease, talk to your doctor who will ask about your symptoms and undertake the following diagnostic testing:
- Blood test – You will be given a simple blood test that can detect the antibodies that result from eating gluten if you have coeliac disease. It is important that you continue eating gluten until you have an accurate diagnosis or the test will not work properly. Your doctor will guide you regarding this.
- Endoscopy– this involves using a thin, flexible tube with a camera and a light to look inside your gut. If evidence of damage is detected a biopsy will be taken and the results sent to the laboratory for testing. You will also need to continue eating gluten for the endoscopy to show an accurate result.
Your doctor and a dietitian can help you to understand which foods you can eat and which you need to avoid. There are plenty of foods that are naturally gluten free including potato, rice, plain meat, fish, eggs, cheese, fruit, vegetables and pulses. Depending where you live, you may be able to get certain gluten free food alternatives on prescription, such as bread and flour mixes.
Once your gut is no longer exposed to gluten and you will feel much better. Talking to other people with the condition and joining organisations like Coeliac UK, can also be helpful.
Natalie has been a consultant gastroenterologist since 2016 and in addition to her private practice she currently holds a post at Imperial College Healthcare NHS Trust, with a specialist interest in gastroenterology and…
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Consultant Gastroenterologist & HPB Physician