What is coeliac disease?
Coeliac disease (pronounced see-liac, spelt celiac disease in other countries) is an autoimmune disease. Gluten, which is found in wheat, barley and rye, triggers an immune reaction in people with coeliac disease. This means that eating gluten damages the lining of the small intestine. Other parts of the body may be affected.
What are the symptoms?
The symptoms of coeliac disease (spelt celiac in America) vary from person to person and can range from very mild to severe.
Possible symptoms may include:
• diarrhea, excessive wind, and/or constipation
• persistent or unexplained gastrointestinal symptoms, such as nausea and vomiting
• recurrent stomach pain, cramping or bloating
• any combination of iron, vitamin B12 or folic acid deficiency
• tiredness and/or headaches
• weight loss (but not in all cases)
• mouth ulcers
• hair loss (alopecia)
• skin rash (dermatitis herpetiformis (DH))
• tooth enamel problems
• repeated miscarriages
• joint and/or bone pain
• neurological (nerve) problems such as ataxia (poor muscle co-ordination) and neuropathy (numbness and tingling in the hands and feet).
Some symptoms may be mistaken as Irritable bowel syndrome (IBS) or wheat intolerance. Stress or getting older can also be a cause of confusion. Contrary to popular belief, you do not need to be underweight or have lost weight to have coeliac disease. Most people are of normal weight or even overweight at diagnosis.
What about children?
In babies, symptoms may develop after weaning onto cereals which contain gluten. Other symptoms in young children include:
• muscle wasting in the arms and legs
• bloated tummy
• failure to gain weight or lose weight after previously growing well
Symptoms in older children vary as they do in adults.
What should I do if I think I have coeliac disease?
If you think you or your child has coeliac disease, you must keep eating gluten and speak to your/their GP for advice. There are three steps in the diagnosis of coeliac disease:
• Discuss your symptoms with your GP.
• Get a simple blood test in your GP’s surgery.
• Get a referral to a gastroenterologist for a gut biopsy.
There are specific blood tests used to diagnosis coeliac disease. They look for antibodies that the body makes in response to eating gluten.
The most accurate blood tests for coeliac disease are:
The test used depends on the laboratory performing the test - they may measure one of the antibodies, or sometimes both. Some people with coeliac disease do not make the usual coeliac disease antibodies. This is called IgA deficiency and so your GP will need to test you differently for the condition. If you have ongoing symptoms that suggest coeliac disease but you have had a negative blood test, then ask your GP to test you for IgA deficiency.
A biopsy involves a small camera called an endoscope being passed through your mouth and stomach into the gut. It is done using an anaesthetic spray to numb your throat or with a sedative given by injection. Biopsies are collected and examined under a microscope to check for gut damage typical in coeliac disease.
These tests for coeliac disease can be done on both adults and children. They confirm a diagnosis of coeliac disease in all cases. In young children, the endoscopy is performed under a general anaesthetic. If you have any concerns about testing, the best thing to do is to talk with your healthcare team.
Once the diagnosis of coeliac disease is made, you can then join Coeliac UK, as a Member you will receive lots of detailed information and support about following a gluten-free diet.