Celiac Disease
Coeliac disease
Coeliac disease is a condition where your immune system attacks your own tissues when you eat gluten. This causes damages your gut (small intestine) so you are unable to take in nutrients.
Coeliac disease can cause a range of symptoms, including diarrhoea, abdominal pain and bloating.
Coeliac disease is caused by an adverse reaction to gluten, which is a dietary protein found in 3 types of cereal:
• Wheat
• Barley
• Rye
These cereals are present in a wide variety of food and beverages, but an
An increase in the range of available gluten-free foods in recent years has made it possible to eat both a healthy and varied gluten-free diet.
Symptoms
Eating foods that contain gluten can trigger a range of gut symptoms, such as:
• diarrhoea, which may smell particularly unpleasant
• stomach aches
• bloating and farting (flatulence)
• indigestion
• constipation
Coeliac disease can also cause more general symptoms, including:
• tiredness (fatigue) as a result of not getting enough nutrients from food (malnutrition)
• unintentional weight loss
• an itchy rash (dermatitis herpetiformis)
• problems getting pregnant (infertility)
• nerve damage (peripheral neuropathy)
• disorders that affect co-ordination, balance and speech (ataxia)
Causes
Coeliac disease is an autoimmune condition. This is where the immune system (the body's defence against infection) mistakenly attacks healthy tissue.
In coeliac disease, the immune system mistakes substances found inside gluten as a threat to the body and attacks them.
This damages the surface of the small bowel (intestines), disrupting the body's ability to take in nutrients from food.
It's not entirely clear what causes the immune system to act this way, but a combination of genetics and the environment appear to play a part.
Diagnosis & Treatment
Diagnosis
Routine testing for coeliac disease is not recommended unless you have symptoms or an increased risk of developing coeliac disease, such as those with a family history of the condition.
Testing for coeliac disease involves eating foods containing gluten to ensure the following tests are accurate:
• blood tests – to help identify people who may have coeliac disease
• a biopsy – to confirm the diagnosis
Blood test
Your GP will take a blood sample and test it for antibodies usually present in the bloodstream of people with coeliac disease.
You should include gluten in your diet when the blood test is carried out because avoiding it could lead to an inaccurate result.
If coeliac disease antibodies are found in your blood, your GP will refer you for a biopsy of your gut.
However, it's sometimes possible to have coeliac disease and not have these antibodies in your blood.
If you continue to have coeliac disease-like symptoms despite having a negative blood test, your GP may still recommend you have a biopsy.
Biopsy
A biopsy is carried out in hospital, usually by a gastroenterologist (a specialist in treating conditions of the stomach and intestines). A biopsy can help confirm a diagnosis of coeliac disease.
If you need to have a biopsy, an endoscope (a thin, flexible tube with a light and camera at one end) will be inserted into your mouth and gently passed down to your small intestine.
Before the procedure, you'll be given a local anaesthetic to numb your throat and perhaps a sedative to help you relax.
The gastroenterologist will pass a tiny biopsy tool through the endoscope to take samples of the lining of your small intestine. The sample will then be examined under a microscope for signs of coeliac disease.
Treatment
There's no cure for coeliac disease, but following a gluten-free diet should help control symptoms and prevent the long-term complications of the condition.
Even if you have mild symptoms, changing your diet is still recommended because continuing to eat gluten can lead to serious complications. This may also be the case if tests show that you have some degree of coeliac disease even if you do not have noticeable symptoms.
It's important to ensure that your gluten-free diet is healthy and balanced.
Complications of coeliac disease
Complications of coeliac disease only tend to affect people who continue to eat gluten, or those who have not yet been diagnosed with the condition, which can be a common problem in milder cases.
Potential long-term complications include:
• weakening of the bones (osteoporosis)
• iron deficiency anaemia
• vitamin B12 and folate deficiency anaemia
Less common and more serious complications include some types of cancers, such as bowel cancer, and problems affecting pregnancy, such as your baby having a low birth weight.
Care at Chartwell Hospital
Available Services
Description title
Gastroenterology Department