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Coeliac Disease

Introduction

People with Coeliac Disease (which is sometimes referred to by other names such as 'gluten sensitive enteropathy' or 'coeliac sprue') are not able to break down proteins that are found in gluten. These proteins can then damage small finger-like parts of the small intestinal lining (called 'villi') which in turn prevents nutrients from the food being absorbed by the body. This is called malabsorption and can lead to malnutrition, even when the person with Coeliac Disease is eating plenty of food.

Causes

Coeliac Disease is an autoimmune disorder and can appear at any point, in childhood as well as adulthood. Genetics is believed to play a role, with the condition understood to be inherited and dormant until triggered by another occurrence. Around one in three people carry the genes for Coeliac Disease, but of these only around 3% will develop the disease. Some statistics indicate up to 1 in 70 Australians could have the condition, whether it has been diagnosed or not.

Coeliac disease is also associated with a range of other medical conditions. The most common autoimmune conditions that are associated with coeliac disease are Type 1 diabetes and autoimmune thyroid disease.

Symptoms

It is worth noting that some people with the condition exhibit no symptoms at all. Where symptoms do occur, they are generally one or more of the following...

  • Pain or bloating of the abdomen.
  • Feeling full all the time.
  • Tiredness / Fatigue.
  • Low / No appetite.
  • Weight loss.
  • Flatulence (wind).
  • Diarrhoea.
  • Oily and / or floating stools.
  • Itchy skin rashes.
  • Low in iron (anaemia).
  • Low bone density (osteoporosis).

Another symptom sometimes present in children is slow growth.

Tests / Diagnosis

  • Blood tests measuring antibody levels in the blood are used to screen for coeliac disease.
  • Upper endoscopy and biopsy of the small bowel remain essential for the diagnosis of coeliac disease.

When the condition is diagnosed, the main treatment is to avoid all food containing gluten, which is present in wheat, oats, rye and barley. Symptoms generally go away within a few weeks of adopting a gluten free diet. Nutritional supplements, particularly iron, may also be required. It is important to note that although symptoms may disappear, coeliac disease is a lifelong disease, and a gluten-free diet must be followed indefinitely.