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Coeliac Disease

The Health Index

Coeliac disease an autoimmune condition rooted in the digestive tract. When a person affected by it ingests gluten, their immune system mistakes the gluten protein  – found in certain grains - as an invader and mounts an immune response in which the intestinal lining is damaged.

Once damaged, the intestinal lining is no longer able to properly absorb nutrients from food. This can lead to malnutrition, a loss of bone density, miscarriages, or subfertility. In the long term, coeliac disease may even cause neurological diseases and certain cancers.

 

It is thought that approximately 1% of the population suffers from coeliac disease, but because symptoms are varied and the damage to the intestine can take years, some researchers believe that perhaps only 20% of people with coeliac disease have been diagnosed.

 

Diagnosis is made by a blood test looking for gluten antibodies, which, if positive, is followed by an endoscopy and biopsy to confirm the diagnosis. To date, there is no treatment for it, but provided that gluten is strictly avoided for life, coeliac sufferers can live a normal, healthy life.

What are the causes?

The causes for the development of coeliac disease are not yet known, but heredity plays a role: 30 to 40 per cent of people appear to be three times more likely to develop the disease because of their genetic make-up. Infections, nutrition, and environmental factors seem to influence the development of the disease.

 

It is not uncommon for coeliac disease to occur alongside other diseases such as diabetes mellitus type 1, autoimmune diseases of the skin or thyroid gland, and genetic abnormalities such as Down's syndrome.

What are the symptoms?

Coeliac disease primarily damages the intestines and digestive system but can also affect and cause symptoms in other parts of the body. Symptoms can be different in children and adults.

Coeliac disease symptoms in children

  • Tiredness

  • Irritability

  • Unexplained weight loss

  • Vomiting

  • Bloating

  • Abdominal pain

  • Persistent diarrhoea or constipation

  • Pale, fatty, smelly stools 

  • Delayed onset of puberty

 

Coeliac disease symptoms in adults

Adults with coeliac disease may experience digestive symptoms. In most cases, however, symptoms also affect other areas of the body. These symptoms may include:

  • Digestive symptoms (e.g. constipation, diarrhoea, bloating, abdominal pain)

  • Fatigue

  • Joint pain and stiffness

  • Iron-deficiency anaemia

  • Weak, brittle bones

  • Seizures

  • Numbness and tingling in the hands and feet

  • Tooth discolouration or loss of enamel

  • Pale sores inside the mouth

  • Irregular menstrual periods

  • Infertility and miscarriage

  • Skin disorders

  • Dermatitis herpetiformis (DH)

  • Reduced short-term memory and difficulty concentrating

Not everyone with coeliac disease develops symptoms. However, they may still experience long-term complications as a result of it. If you know that coeliac disease runs in your family, tell your doctor, even if you are not aware of any symptoms. Schedule an appointment with your doctor right away if you suspect that you or your child has coeliac disease. If diagnosis and treatment are delayed, complications are more likely to occur, and recovery is slower.

How can a nutrition practitioner help?

Coeliac disease does not cause any symptoms as long as gluten is completely and strictly avoided for life. The protein occurs in just a few grains, which shouldn’t be too difficult to avoid. Unfortunately, however, the protein hides in many food and even non-food products where you would not expect it. Your nutrition practitioner can help you identify common pitfalls, show you alternatives to gluten-containing foods, and create a diet plan that works for you.

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Specialist