Why Coeliac Disease Looks Different for Everyone

Coeliac disease manifests with a host of symptoms ranging from abdominal bloating to blistering skin. Coexisting conditions include lactose intolerance, osteoporosis, as well other disorders. Coeliac disease is an autoimmune disorder that can occur at any stage of life, from infancy to old age. With a wide-range of symptoms, coeliac disease is a real ‘chameleon’ that often presents differently for each person, making it extremely difficult to diagnose. Many people with coeliac disease can remain undiagnosed for several years.

In individuals with coeliac disease, consuming gluten causes inflammation of the small intestine. This can impact different organs and systems in the body – and trigger a raft of symptoms with varying degrees of severity. Individuals with coeliac disease can even be fully asymptomatic. Since all types of coeliac disease are associated with damage to the lining of the small intestine, it is very important to see a doctor if you suspect you may have the condition.

Coeliac disease damages the delicate lining of the small intestine, often – but not always – leading to gastrointestinal symptoms. However, it can also cause more general symptoms, often outside of the gut. In the long term, the chronic inflammation in the small intestine prevents important nutrients from being absorbed by the body, leading to nutrient deficiencies.

Such as

• diarrhoea or constipation                  
• vomiting with or without nausea       
• a feeling of fullness after meals       
• bloating or distension
• abdominal pain

Such as

• unexplained weight loss
• exhaustion, fatigue
• muscle weakness or pain
• joint pain, motor impairment
• recurring mouth sores
• delayed growth in children.

If any of these symptoms persist for more than four weeks, experts advise you to be tested for coeliac disease.

You should also be tested for coeliac disease if you have certain unexplained abnormal blood results or illnesses such as unexplained vitamin or mineral deficiencies, particularly vitamin B12, folic acid, iron or calcium deficiencies. Conditions such as anaemia or osteoporosis can also be associated with coeliac disease. Elevated liver enzymes (transaminases) may also be a sign of coeliac disease. But the list of possible coexisting conditions is even longer, and includes hair loss, lactose intolerance, migraine, depression, as well as joint symptoms, neurological disorders and infertility. A host of other signs and symptoms have also observed in coeliac disease. For example, dermatitis herpetiformis is a version of coeliac disease characterised by an itchy, blistering rash.

Some people have a genetically related increased risk of coeliac disease, for example, if you have a first-degree relative with coeliac disease, you have a 10 times higher risk of developing the condition yourself. Individuals with genetic syndromes such as Downs syndrome, Turner syndrome or Williams syndrome should also be tested for coeliac disease. People with certain autoimmune disorders are also at greater risk of coeliac disease. These disorders include:

• Type 1 diabetes
• Autoimmune liver diseases
• Hashimoto thyroiditis and Grave's disease
• Rheumatoid arthritis.

No matter what the symptoms, coexisting conditions or risk factors, you should see your GP if you suspect you may have coeliac disease. The first step involves a blood test. Depending on the results, you will be referred to a gastroenterologist (a doctor who specialises in gut health) to confirm the diagnosis. If a diagnosis of coeliac disease is confirmed, a strict gluten-free diet can enable the small intestine to fully heal. Please note: Do not remove gluten from your diet before testing, otherwise you may receive a false negative result.