What is Coeliac disease?

Coeliac disease is a condition where the lining of the small intestine becomes damaged by the immune system as a consequence of exposure to gluten, a protein found in wheat, barley, rye and oats. Some of the more common symptoms can include one or more of abdominal pain, nausea, diarrhoea, weight loss and fatigue. Iron, folate deficiency and anaemia along with osteoporosis and other nutritional, vitamin and mineral deficiencies can also occur due to the intestinal damage. Less common complications include miscarriages, mouth ulcers and skin conditions. It is important to realise that some patients with coeliac disease may have no symptoms at all. Conversely, there are many individuals who experience symptoms from wheat products that do not have coeliac disease, and are considered to have gluten intolerance. In spite of their symptoms, these patients have no or minimal intestinal damage and are unlikely to experience the nutrient and mineral deficiencies.

How is Coeliac diagnosed?

Coeliac disease is found in about 1% of the general population and up to 10% of close relatives of individuals with coeliac disease. While a patient’s symptoms can be a useful guide, these cannot be used alone to make the diagnosis. Blood tests, including coeliac serology are helpful, but to confirm the diagnosis a biopsy (tissue sample) of the small intestine is required. This is done through a procedure known as a gastroscopy.

Treatment of Coeliac disease

In the majority of cases, a gluten free diet leads to healing of the damaged intestinal lining and resolution of symptoms. In a very small proportion of patients, other treatments including medication may be required. The management of coeliac disease also requires monitoring of various minerals and nutrients and an assessment of bone density.