What is Coeliac Disease?

This week, March 13-20 is Coeliac Awareness Week.

What is Coeliac Disease?

A person with coeliac disease has an abnormal immune reaction to gluten. Gluten is a protein found in wheat, rye, barley, triticale and possibly oats. When a person with coeliac disease eats a food containing gluten their intestinal villi (small finger like projections that line the intestinal wall) gets inflammed. Over time these projections can flatten out. The problem with this is that the villi is responsible for absorption of nutrients in the gut.

How Do You Get Coeliac Disease?
Coeliac disease affects approximately 1% of the population but it is likely 75% of those with coeliac disease remain undiagnosed. More adults are diagnosed than children and it is more common among Caucasians. If you have a first degree relative that has coeliac disease then it may be likely that you are susceptible to it as well. This is because those with coeliac disease have a specific marker called HLA on their cells. This gene is present in about 30% of the population. A blood test or buccal swab can test for the presence of this gene but only about 3% of those with the positive genetics will go on to develop coeliac disease. This means that this test can only be used to rule out coeliac disease.

Environmental factors also play a part, for example there is a larger prevalence of coeliac disease in cultures that eat wheat.

What are the Symptoms of Coeliac Disease?

Many people suffering from coeliac disease may have no symptoms or only a few non specific complaints. This means that many can remain undiagnosed for several years. 
Some common symptoms:

  • Iron deficiency anaemia or other vitamin and/or mineral deficiencies 
  • Weight loss
  • Diarrhoea, bloating, flatulence, nausea, vomiting, steatorrhoea, abdominal cramps
  • Muscle wasting
  • Weakness and tiredness
  • Osteoporosis
  • Infertility
  • Failure to thrive in children
  • Skin rashes and bruising
  • Recurrent mouth ulcers
  • headaches and dizziness
Is There a Treatment or Cure?
Coeliac disease is treated with a gluten free diet. A vaccine is in development and is currently undergoing clinical trials but the best treatment we have now is still a gluten free diet. Although this may be a bit daunting it's important that there are risks involved in not treating coeliac disease.
  • Chronic poor health
  • Increased risk of GI cancers 
  • Infertility and miscarriages
  • Refractory coeliac disease (late diagnosed coeliac disease)
  • Liver disorders
  • Neurological disorders (ataxia, epilepsy, early onset dementia)
  • Increased risk of autoimmune diseases such as diabetes and Dermatitis herpetiformis (skin condition)
  • Damage to teeth 
  • Poor nutritional status  such as anaemia, low bone mineral density, poor absorption of protein, fat, carbohydrates, calcium, magnesium, zinc and vitamins
  • Osteoporosis
Okay How Do I get Tested? 

First of all don't start a gluten free diet just yet. The test used to diagnose coeliac disease will not be accurate if you have not been eating gluten and can give you a false negative. Therefore wheat products must be eaten for 6 weeks prior to a biopsy test.

The first test is usually a blood screening test that looks for antibodies in the blood. A person with untreated coeliac disease often has increased levels of these. However a blood test can not diagnose coeliac disease and it MUST be followed by a small bowel biopsy.

A small bowel biopsy is a conducted to look at the villi in the small intestines. This requires a gastroscopy procedure which is when they look at your bowel and collect small samples to look at under the microscope. This is to confirm the presence of a flattened villi, a sign coeliac disease.

A second biopsy usually occurs after at least 6 months on a gluten free diet. This should show recovery of the intestinal villi.

It is very important that this procedure of diagnosis is followed. Although it seems slow it is the gold standard for diagnosis. Coeliac disease is a life long medical condition that benefits greatly from a proper diagnosis. By obtaining a proper diagnosis you can be assured that the symptoms experienced are caused by coeliac disease and not another medical condition. There are other causes of abnormal intestinal villi and it's important to make sure what you have is coeliac disease as treatment is a life long strict gluten free diet.

The Gluten Free Diet

Treatment of coeliac disease is self managed. How strictly you adhere to the gluten free diet is in your control so it's important to be aware of foods that contain gluten and how to read and interpret food labels. Symptoms often take 6-12 months to settle so keep at the diet even if you do not see any immediate effects. The Coeliac Society has a great collection of resources for anyone who has coeliac disease ranging from ingredient list booklets, magazines, restaurant cards, seminars, cooking demonstrations, gluten free food monthly discounts at Coles and recipes etc. It costs a small annual membership fee but it's really worth it! With the amount of gluten free products in the market now it's become a lot easier for people with coeliac disease to still have many of the foods they enjoy.

Remember individual consultations with an accredited practising dietitian can help manage coeliac disease and answer any questions you might have. 


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The information presented on this blog acts as general nutrition advice and is not tailored to meet individual needs. It should not be used as a replacement for any medical advice you have recieved from medical practitioners. Please discuss any concerns for your health with your doctor or Accredited Practicing Dietitian before starting a new dietary or exercise regime as they can give more personalised recommendations.

I make every effort to ensure information on Nutrition with Wendy is correct and up to date however nutrition is an evolving field and discrepancies can arise. If the information here appears incorrect or out of date please let me know and I will do my best to update my posts.