Coeliac Disease

Other names: Celiac Disease, Gluten Enteropathy, Coeliac Sprue, Gluten Intolerance
Coeliac disease is a disorder of the small intestine. It is caused by a sensitivity to gluten, a protein of wheat and some other cereals. Gliadin (a component of gluten) damages the lining of the small intestine so that it is unable to absorb nutrients into the body properly.

Coeliac disease can occur at any age and is more common than is often recognised. It may also be associated with diabetes mellitus and autoimmune disorders. If one person in a family has coeliac disease, it is more common in other family members.

Symptoms

People with coeliac disease may have no symptoms and therefore be unaware of having the disease. They may have non-specific conditions such as tiredness, weight loss or anaemia. Or they may experience diarrhoea, abdominal pain and many other symptoms. Sometimes a rash – known as dermatitis herpetiformis – is associated with coeliac disease.

Diagnosis

The diagnosis is made by a high index of suspicion, and by screening close relatives for coeliac disease. Blood tests can be very useful in suggesting the diagnosis (serum folate, gliadin antibodies and endomysial transglutaminase antibodies). However, the diagnosis is made by taking tissue samples (biopsies) of the lining (mucosa) of the small intestine for examination by a pathologist. If the lining is found to be 'flat' (ie: there is loss of the normal highly specialised surface) and if this returns to normal once gluten has been removed from the diet, the diagnosis is confirmed.

Treatment/Therapy

A gluten-free diet is the treatment for coeliac disease (see Diet Information). Patients need to stay on the gluten-free diet for life. It is also important that any nutritional deficiencies be detected and treated. A dietitian should be consulted for advice.