All about coeliac disease

Coeliac disease is an autoimmune condition related to gluten, a protein found in the cereals wheat, barley and rye. It is not an allergy. When a person has coeliac disease, the immune system mistakenly identifies substances found inside gluten as a threat to the body and attacks them. This damages the lining of the small intestine, and disrupts the body’s capacity to absorb nutrients from food.    

A person who has coeliac disease may experience symptoms including abdominal pain, bloating, malabsorption, diarrhoea or constipation and unintentional weight loss, among others.  

The only known treatment for coeliac disease is to stop eating gluten. A gluten-free diet will usually quickly end the symptoms associated with the disease. 

Coeliac disease seems to have a hereditary element, but it is not automatically passed on in families. Researchers believe that some environmental factors may also help to trigger the condition in a person who has a genetic disposition to it, but more research is required to fully understand the causes of coeliac disease. 

If you have a close relative with coeliac disease, such as a parent or sibling, this means you have an increased chance of developing the condition.  

The risk is approximately 10% for a person who has a family history of coeliac disease. If you have an identical twin with coeliac disease, there is a 75% chance you also will get the condition. So genetics create a risk but it is not automatic.   

Research shows that coeliac disease is strongly associated with a number of genetic mutations that affect a group of genes known as the HLA-DQ genes. These genes are responsible for the development of our immune system. However, mutations in the HLA-DQ genes are quite common, occurring in around one third of the population. This would suggest that there is something else, possibly environmental factors, that triggers coeliac disease in certain individuals.  

To be clear, coeliac disease is not something you can catch, like a virus. And there is no knowledge at present on how to reduce the risk of developing it if you have a family history.  

 There are different types of coeliac disease including: 

1. Classical/symptomatic coeliac disease. Patients show signs and symptoms of malabsorption of nutrients, including diarrhoea and weight loss or failure to grow or delayed puberty in the case of children. 
2. Non-classical/asymptomatic coeliac disease. Symptoms that occur outside the intestine such as iron-deficiency anaemia, chronic fatigue, migraines, tingling or numbness in hands and feet amongst others, may be classed as non-classical coeliac disease. Some individuals experience no symptoms at all and have asymptomatic coeliac disease.

If left untreated, coeliac disease can have serious implications for a person’s health.  

Damage caused to the villi, finger-like projections in our intestine that absorb nutrients into the bloodstream, means that malabsorption of nutrients from food is a typical effect of coeliac disease. This can show up in symptoms such as anaemia, and also lead to osteoporosis, when our bones become brittle and weak.  

Untreated coeliac disease can also contribute to complications during pregnancy. A person with untreated coeliac disease also has a slightly greater chance of developing certain forms of cancer.  

More common that you might think. Coeliac UK, the national patient charity for people with coeliac disease says that around one in a hundred people have coeliac disease, with similar estimates made in other countries. In the UK, however, only 30% of people who have the condition have been diagnosed.  

Coeliac disease is more frequently diagnosed among women than in men.