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Digestive health centre

Coeliac disease

What is coeliac disease?

A person with coeliac disease has a bad reaction to gluten in food and drink.

Coeliac disease isn't a food allergy or intolerance. It is an autoimmune condition where the body's immune system wrongly attacks its own healthy tissue in the small bowel when gluten is eaten - a protein found in wheat, rye and barley cereal.

There is no cure but it can be managed by following a gluten-free diet.

It is relatively common affecting around 1 in 100 people in the UK.

Causes

Normally, the body's immune system is designed to protect it from foreign invaders. When people with coeliac disease eat foods containing gluten, their immune system forms antibodies to gluten that then attack the intestinal lining. This causes inflammation in the intestines and damages the villi, the hair-like structures on the lining of the small intestine. Nutrients from food are absorbed by the villi. If the villi are damaged, the person cannot absorb nutrients and ends up malnourished.

Symptoms

These vary and can include:

Other health problems

Having coeliac disease can lead to other health problems, including:

Patients may have other autoimmune conditions, including:

Diagnosis

A physical examination will be carried out by a doctor and the symptoms and medical history will be discussed to start to diagnose the disease. Blood tests may be arranged to check for higher levels of certain types of antibodies - substances produced by the immune system to fight harmful invaders.

Tests may also be done to detect nutritional deficiencies, such as a blood test to detect iron levels - a low level of iron can cause anaemia. A poo (stool) sample may be tested to detect poor fat absorption from food.

A referral may be made for a biopsy tissue sample to be taken from the small intestine to check for damage to the villi. This is done with a thin, hollow tube - called an endoscope - inserted through the mouth and into the small intestine.

The sample taken is sent for laboratory testing under a microscope as part of making the diagnosis.

Treatment

After a diagnosis is confirmed treatment involves avoiding gluten for life. A referral to a dietitian may be arranged.

WebMD Medical Reference

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