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Coeliac disease

Updated: Aug 21, 2023

Coeliac disease is an autoimmune condition triggered by the ingestion of gluten (found in wheat, barley and rye) in genetically susceptible individuals.

What is Coeliac disease?

Coeliac disease is one of the most chronic digestive disorders with 1 in 100 people in the UK affected, but thought only 30% of sufferers are clinically diagnosed.

Gluten sets off an autoimmune reaction leading to destruction of the villi, the tiny finger-like projections lining the small intestine. There is no cure, and for those diagnosed with coeliac disease, it is essential to follow a gluten-free diet for life.

What are the symptoms?

Gastrointestinal symptoms include constipation or diarrhoea, stomach aches and pains, bloating, flatulence and indigestion, which may be commonly dismissed as IBS. As the villi become damaged and blunted, the ability to absorb nutrients from our food is compromised leading to weight loss, iron deficiency, chronic fatigue or weakness, reduced bone density, and neurological symptoms such as depression, anxiety and brain fog.

What Causes Coeliac Disease?

Healthy villi are vital to the proper digestion and absorption of food. Coeliac patients produce antibodies that, in combination with hormone-like substances called cytokines attack the intestine and flatten the villi, leading to malabsorption and illness. This autoimmune response is the main difference between gluten sensitivity and coeliac disease.

In coeliac disease there is normally a genetic component involved. We know that the genetic predisposition markers, HLA- DQ2 or -DQ8, must almost always be present in people with coeliac disease. This is not the case with wheat allergy and gluten sensitivity. However, having the genes does not mean you will develop coeliac disease. Other environmental factors (such as stress, medications, toxins viruses and bacteria) are likely involved in addition to consuming gluten that results in increased intestinal permeability, and the development of the disease.

If you have a family member with coeliac disease your risk of developing the disease is greater. It is also more common if you suffer with other autoimmune or genetic diseases like Type 1 diabetes Addison’s disease, psoriasis, and Hashimoto’s thyroiditis.

What foods should I avoid?

Gluten is a protein found in the grains wheat, rye and barley. Some people with coeliac disease are also sensitive to oats. Obvious sources of gluten include foods that contain traditional flour such as, breads, pasta, cereals, cakes and biscuits but also found in many favourite foods such as fish fingers, sausages, gravies, sauces, stock cubes, soy sauce and even in some chocolate.

Where can I find more information?

If you are worried about any of the digestive or wider symptoms described, it is always recommended to see your GP. Coeliac UK is a charity dedicated to supporting coeliac sufferers, with lots of free information including recipes, eating out and travel guides, and workshops to support a diagnosis.

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