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Symptoms
The symptoms associated with coeliac disease can vary from person to person. They may be gut-related, for example:
- Diarrhoea
- Vomiting
- Abdominal pain
- Wind
- Bloating
- Constipation
However, the symptoms of coeliac disease are often more general and felt outside of the gut, for example:
- Headaches
- Extreme tiredness
- Anaemia
- Joint pain
The symptoms of coeliac disease can be so varied that it may take a long time for a correct diagnosis to be made. Symptoms often mimic those of other common complaints, such as irritable bowel syndrome (IBS). Your doctor should test you for coeliac disease before making a diagnosis of IBS.
Some people with coeliac disease experience no symptoms at all, however gluten will still be causing damage within the body. If left untreated, long-term complications may develop, including: osteoporosis, anaemias, fertility issues and, in rare cases, some forms of cancer.
Diagnosis
The first stage of testing for coeliac disease involves a blood test that looks for coeliac antibodies. This test can usually be performed in your GP surgery.
If your blood test is positive, you will be referred to a gut specialist (gastroenterologist) at your local hospital. Depending on the levels of antibodies present in your blood, you may need to undergo a procedure called an ‘endoscopy’. This allows the doctor to examine the health of your small bowel. During the endoscopy, a small sample of cells from your gut will be taken for closer examination, this is called a small bowel biopsy. Some people with highly positive coeliac antibody levels (≥ 10 times or more higher than the upper limit of normal) may be diagnosed with coeliac disease without having to undergo an endoscopy and biopsy, your gastroenterologist will discuss this possibility with you.
If an endoscopy and biopsy is right diagnosis pathway for you and the results show signs of gut damage associated with coeliac disease, you will be given a formal diagnosis of the condition.
IMPORTANT: It is essential that you continue to eat a normal gluten-containing diet throughout the diagnostic process, otherwise the results of any coeliac tests may be falsely negative. Do not start a gluten-free diet until your diagnosis has been confirmed by a specialist. It is recommended that you consume 3-6g of gluten daily for at least 6 weeks prior to undergoing these tests. This is roughly equivalent to 1-2 slices of bread per day.
