In light of Coeliac Disease Awareness week in May 2023, our very own Dr Dawn has written an informative piece about exactly what it is. and how it can affect the sufferers daily life. 1 in 100 people in the UK have coeliac disease, but only 36% are diagnosed. So the mission for the awareness week is to shine a light on this misunderstood disease and get more people on the road to recovery.
Coeliac disease is a condition where the body produces antibodies to attack healthy tissue. In the case of coeliac disease, the immune system sees substances containing gluten as foreign and a threat to the body so attacks them causing damage to the small bowel, which then means other nutrients can’t be absorbed properly.
Who gets coeliac disease?
Coeliac disease affects one in a hundred people in the UK. It is three times more common in women than it is in men and if a parent, sibling or child has coeliac disease, then that increases your risk. It is also more common in people with type 1 diabetes and autoimmune thyroid disease and in people with Down’s syndrome or Turner syndrome.
What is gluten?
Gluten is a protein found in barley, wheat and rye. This means it is found in lots of foods including bread, pasta, cakes, cereals, biscuits and some sauces and ready meals.
What are the symptoms of coeliac disease?
The symptoms of coeliac disease are very variable. Sometimes the diagnosis can be missed for a long while because the symptoms are mild and vague, but for others the symptoms of diarrhoea or constipation, stomach ache, bloating and flatulence after eating gluten are severe and debilitating and the diagnosis is more obvious.
Sometimes people will feel fatigued or may lose weight unintentionally.
If coeliac disease is affecting absorption of nutrients from the diet it may present with symptoms of vitamin or mineral deficiencies.
How is coeliac disease diagnosed?
If your doctor suspects coeliac disease, he will arrange a blood test to look for antibodies against gluten. It is important that you eat gluten in at least one meal every day for six weeks before the blood test. That can be tough for some people as it means you are left with unpleasant symptoms for weeks before a diagnosis can be made, but if you are not eating gluten at the time of diagnosis, the test could be falsely negative.
If you test positive for these antibodies, your doctor will refer you to a specialist for a biopsy. This is done by using a camera on a telescope that is put into your mouth and down into your small intestine. It is usually done in out-patients using a local anaesthetic.
It is possible to have a negative blood test but still have coeliac disease, so if your symptoms persist, your GP may still refer you for a biopsy.
How is coeliac disease treated?
If you test positive for coeliac disease, you will be asked to exclude gluten completely from your diet. You may be referred to a dietician to help you with identifying foods containing gluten. This will be a challenge at first, but symptoms should improve with weeks of cutting out gluten.
What are the long-term complications of coeliac disease?
If coeliac disease is undiagnosed or if you continue to eat gluten after diagnosis you risk becoming low in vitamins and minerals such as iron and B12 which can make you anaemic. You may also absorb less calcium from your diet which increases your risk of developing osteoporosis.
People with coeliac disease are also more likely to become lactose intolerant.
Sometimes coeliac disease can affect a woman’s fertility and if she does become pregnant, there is an increased risk that the baby may be born smaller than expected.
Coeliac disease is also associated with an intensely itchy rash called dermatitis herpetiformis, which usually appears on elbows, knees and buttocks.
There is also a rare but serious increased risk of developing small bowel cancer or lymphoma or Hodgkin lymphoma, but if you follow a gluten free diet for three to five years, this risk is no longer there.