Coeliac disease affects at least 1 person in 70, although perhaps as many as 4 out of 5 people who have the condition don’t know they have it.
Gluten is a protein that is found in many grains such as wheat, barley, oats and rye. These grains are often used to make breads, pasta and cereals. Because many corn and rice products are produced in factories that also manufacture wheat products, they can also be contaminated with wheat gluten.
Hidden sources of gluten include additives such as modified food starch, preservatives and stabilisers made with wheat.
Gluten may also be found in everyday products such as medicines, vitamins and lip balms.
Coeliac disease is caused by an abnormal reaction by your immune system to the protein gluten.
If undiagnosed, the condition can cause long-term poor health and other less common effects such as:
It is important to see your doctor if you suspect you may have the condition.
Coeliac disease can develop at any stage in life, from infancy to old age. It occurs in family groups and has a strong genetic tendency.
Environmental factors are also believed to play a role in the development of the condition, although the exact nature of these remains unclear.
The symptoms of coeliac disease are different for everyone, depending on the person's age and degree of damage to the bowel. They can be similar to those of several other conditions, such as irritable bowel syndrome, which can complicate diagnosis.In adults, common symptoms include:
Anaemia is also more common in people with coeliac disease, particularly anaemia due to iron or folic acid deficiency. The anaemia will either not respond to treatment, or will recur after treatment until the underlying cause (i.e. coeliac disease) is identified and treated.
Less commonly, adults may experience:
In children, symptoms do not appear until gluten-containing foods are introduced into the diet. It is also possible for symptoms to appear later. The common symptoms include:
Because the symptoms of coeliac disease are similar to those of many other gastrointestinal diseases, the diagnosis of coeliac disease can be challenging. It is usually diagnosed with blood tests, bowel biopsy and gene test. It is important to keep eating gluten until after diagnosis. If the gluten-free diet is started before diagnosis, this may affect the accuracy of investigations such as blood tests and biopsies.
Feeling better on a gluten-free diet is not enough to confirm the diagnosis of coeliac disease.
Diagnostic tests for coeliac disease
There is no known cure for coeliac disease. The only treatment is following a gluten-free diet, which will allow most people to return to normal health.
People with coeliac disease remain sensitive to gluten throughout their life. If gluten remains in the diet, damage to the small bowel will still be happening, even if symptoms disappear.
People with coeliac disease are genetically predisposed to developing some other autoimmune conditions, or already have these conditions when they are diagnosed with coeliac disease. This is because it is likely there is a common gene link between these conditions. These include:
Therefore if you have coeliac disease, talk to your GP about whether you have the symptoms of any of these conditions, particularly thyroid disease, as this is the most common.
For more information, contact Coeliac New Zealand, a support group for adults and children with coeliac disease.
What is coeliac disease? Coeliac New ZealandCoeliac disease overview University of Chicago Celiac disease center (USA)