What is Coeliac Disease
Coeliac disease is a condition in which the lining of the small intestine becomes damaged when it is exposed to even small amounts of gluten, a protein found in wheat, barley, rye and oats. As a result, affected patients absorb food and nutrients poorly. This can result in bowel symptoms and deficiencies of vitamins, minerals and other nutrients. Coeliac disease is successfully treated by avoiding eating all foods containing gluten. This is called a “gluten-free diet“. Following a gluten-free diet after the diagnosis of Coeliac disease should allow an improvement in symptoms and restoration of health.
How common is it?
It is relatively uncommon. In Australia about one person in 2000 is diagnosed with the condition, but it may be much more frequent than this, maybe close to 1% of people of Northern European descent.
Does it run in families?
Yes, it certainly can. About one in ten close family relatives of an affected patient may also have coeliac disease.
What are the symptoms?
Coeliac disease can vary in its symptoms, ranging from many to none at all. There are no specific symptoms of the disease. Diarrhoea, loss of weight, nausea, flatulence and abdominal discomfort are common complaints. Tiredness and weakness are also common, usually because of a degree of iron and/or folic acid deficiency, sometimes resulting in anaemia. Some patients may also be diagnosed following investigation for osteoporosis. Less commonly, mouth ulceration, recurring miscarriages or infertility can be the presenting features in adults.
In children, coeliac disease often causes poor weight gain, delayed growth and development, irritability and a poor appetite, in addition to bowel problems and anaemia. Of course many of the above-mentioned complaints are very common in the community and are usually not due to coeliac disease. Nonetheless, it is widely accepted now that this condition is under-diagnosed and should be considered in a broader range of patients than has been the practice in the past. Undoubtedly some people with “irritable bowel syndrome” may have undiagnosed coeliac disease.
What should I do if I think I have Coeliac Disease?
You should first approach your general practitioner. A medical history and an examination will be performed and, if thought necessary, further tests will be undertaken to help diagnose the condition. You may be referred to a specialist.
If Coeliac disease is suspected, a gluten-free diet should never be started until the condition has been properly diagnosed. Otherwise, this will interfere with establishing the correct diagnosis. The gluten-free diet should always be undertaken with medical supervision.
How is Coeliac Disease diagnosed?
Your doctor’s assessment and, if appropriate, some blood tests will determine whether Coeliac disease is likely. However, the diagnosis can only be properly made by a pathology examination of a biopsy taken from the intestine. Nowadays, this is quite a simple, safe and painless procedure that does not require you to stay in hospital overnight.
What should I do if someone in my family has Coeliac Disease?
Again, your local doctor should be your first contact. There are blood tests available that are useful to screen for Coeliac disease. You may like to mention this website to indicate where you have read about the condition.
What is the treatment if I have Coeliac Disease?
Coeliac disease is treated by a strict gluten-free diet. Medication is rarely necessary. This diet needs to be continued for life because the sensitivity to gluten does not disappear.
Basic information regarding the diet can be obtained from your doctor. A visit to a dietitian is highly recommended for a comprehensive explanation and planning of the gluten-free diet. In addition, the Coeliac Society of Australia and its state branches are invaluable aids. They are self-help organisations for people with Coeliac disease and their families and have access to excellent information, including the availability of special gluten-free foods and recipes.
You will need ongoing monitoring of your health through your local doctor, gastroenterologist and/or dietitian. It is usual practice to repeat the biopsy about 6-12 months after diagnosis. It is also recommended to have certain blood tests periodically at the discretion of your doctor. A bone density test should also be performed at the time of diagnosis and thereafter as indicated by your doctor.
Long-term problems associated with failure to adhere to a strict gluten-free diet include increased risk of bowel lymphoma (a type of cancer), osteoporosis, infertility and chronic ill health. The risk of these is no greater than normal when a gluten-free diet is followed.