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Coeliac disease

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Coeliac disease

What is coeliac disease?

Coeliac disease is a condition in which the intestine has an abnormal immune reaction to gluten in the diet. Gluten is a protein found in wheat or related grains, and is found in many types of food. People with coeliac disease have to follow a strict gluten-free diet.

Normally, immune cells are designed to protect the body against invaders, but in coeliac disease the body mistakenly perceives gluten as the enemy and attacks it. In the process, the small intestine becomes inflamed and impaired in absorbing nutrients.

What causes coeliac disease?

The exact cause of coeliac disease is unknown, but there is clear evidence of a genetic factor. It would seem that the abnormal reaction to gluten is triggered in susceptible people by some event such as a virus.

In Northern Europe, between 1 in 200 and 1 in 300 people have coeliac disease, and the condition is thought to be especially common among the Irish population.

What are the symptoms of coeliac disease?

Symptoms can include:

  • Diarrhoea
  • Constipation
  • Nausea
  • Chronic fatigue
  • Weight loss
  • Mouth ulcers
  • Anaemia, due to poor absorption of iron
  • Stunted growth in children.

When the intestine is damaged, the body cannot absorb all the necessary nutrients from food, so people with celiac disease may also suffer from various nutritional deficiencies, such as:

  • Poor absorption of vitamin K, responsible for blood clotting, means that people with coeliac disease bruise easily
  • Scaling skin, due to poor absorption of vitamin A
  • Muscle spasms, due to poor absorption of vitamin D and calcium
  • Osteoporosis, due to poor absorption of calcium and vitamin D.

If left untreated, other complications may arise. For instance, there is an increased risk of cancers of the intestine in unmanaged coeliac disease.

How is coeliac disease diagnosed?

Your doctor will normally conduct a physical examination and ask you about your symptoms. You may have a blood test to look for levels of various antibodies.

To give a definite diagnosis, a biopsy may be necessary. This involves removing a small sample of tissue from the lining of your small intestine, which will be examined under the microscope.

What is the treatment for coeliac disease?

The only treatment generally required for coeliac disease is to follow a strict gluten-free diet. Because this can be difficult to achieve however, consultation with a dietician may be useful.

Symptoms normally improve within days of eliminating gluten from the diet and the small intestine can be completely healed within a few months. However, it is important to remain on a gluten-free diet even after symptoms have disappeared, in order to stop the disease returning.

In rare cases, a short course of corticosteroids may be required to reduce the inflammation caused by gluten. Treatment for associated problems may also be necessary.

What foods can I eat?

Some coeliacs are more sensitive to gluten than others, however it is advisable to cut as much gluten out of the diet as possible.

Many foods are naturally gluten-free, such as unprocessed fruit, vegetables, milk, eggs, rice, fish and meat.

Foods that contain gluten include breads, biscuits, cakes, pastries, pasta, some cereals and certain soups and sauces.

However, many food manufacturers in Ireland now produce gluten-free products, and most of the major supermarkets in Ireland stock gluten-free breads, biscuits, pastas, cereals and other products.

Can I prevent coeliac disease?

As the exact cause of coeliac disease is not known at present, it is not possible to predict who might be susceptible to the disease and how to prevent it. If coeliac disease runs in your family, however, you should be on the lookout for any symptoms.

One precaution that can be taken at present is to avoid weaning infants onto gluten too early (before 6 months), is thought to sometimes be a trigger for coeliac disease. Breastfeeding babies is an ideal way of postponing the introduction of food with gluten to babies.

Where can I get more information and advice?

The Coeliac Society of Ireland is a good source of information for Irish coeliacs. They circulate a newsletter, publish a list of gluten-free foods and hold regular meetings around the country to provide people with updates on gluten-free products, opportunities to get local information about suppliers, and a chance to meet others with the same condition.

Contact the Coeliac Society at Tel, 01 872 1471, Email, coeliac@iol.ie or visit their website at www.coeliac.ie

Reviewed: December 14, 2006

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Last Reviewed: 14th December 2006



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