Coeliac disease is a chronic autoimmune condition where the immune system attacks the small intestine when gluten is consumed. Gluten is a protein found in wheat, barley, and rye, which makes it a common ingredient in many everyday foods. For those with coeliac disease, even a tiny amount of gluten can trigger an immune response, leading to inflammation and damage to the lining of the small intestine. This can cause various complications, including malabsorption of nutrients and other long-term health issues.
Signs and symptoms of coeliac disease
Recognising the signs and symptoms of coeliac disease is crucial for early diagnosis and management. Symptoms can vary widely between people, which is why the condition is sometimes difficult to detect. Common coeliac symptoms include:
- Persistent bloating and severe abdominal pain
- Chronic diarrhoea or constipation
- Fatigue and weakness
- Unintended weight loss
- Iron-deficiency anaemia
- Mouth ulcers
- Dermatitis herpetiformis (a skin rash associated with coeliac disease)
- Neurological symptoms such as headaches or numbness
- Delayed growth in children
Some people may experience few or no symptoms, making diagnosis even more challenging. This is known as “silent” coeliac disease.
How is coeliac disease diagnosed?
If you suspect you have coeliac disease, it’s essential to speak to your GP before making any changes to your diet. Diagnosis typically involves:
- Blood tests: These check for specific antibodies, such as tissue transglutaminase antibodies (tTGA) and endomysial antibodies (EMA). These markers indicate an immune response to gluten.
- Endoscopy and biopsy: If blood tests suggest coeliac disease, a specialist may perform an endoscopy to take small tissue samples from the small intestine. This biopsy confirms damage to the intestinal lining caused by gluten.
It is crucial to continue eating gluten before testing to avoid false-negative results.
How serious is coeliac disease?
Untreated coeliac disease can lead to severe health complications, such as:
- Nutritional deficiencies (iron, calcium, vitamin D, and B12)
- Osteoporosis
- Infertility and pregnancy complications
- Increased risk of certain cancers, including intestinal lymphoma
Following a strict gluten-free diet is the only effective way to manage the condition and prevent these complications.
Adjusting your lifestyle
Receiving a diagnosis of coeliac disease can feel overwhelming, but with the right support and knowledge, it’s entirely possible to live a healthy, fulfilling life. The cornerstone of managing coeliac disease is adopting a gluten-free diet for life. This means avoiding all foods containing wheat, barley, and rye. Cross-contamination is another critical consideration, requiring vigilance in food preparation and dining out.
Coeliac diet plan: What to eat and avoid
Safe foods:
- Naturally gluten-free grains: Rice, quinoa, buckwheat, and corn
- Fresh fruits and vegetables
- Meat, fish, eggs, and dairy (unprocessed)
- Legumes and nuts
Foods to avoid:
- Bread, pasta, cereals, and baked goods made with wheat, barley, or rye
- Processed foods with hidden gluten, such as soups, sauces, and gravies
- Beer, unless labelled gluten-free
Meal ideas:
- Breakfast: Gluten-free oats with fresh fruit and yogurt
- Lunch: Grilled chicken salad with quinoa and a lemon dressing
- Dinner: Baked salmon with roasted vegetables and mashed sweet potatoes
- Snacks: Rice cakes with nut butter, gluten-free crackers with cheese
Living with your diagnosis
In the UK, it is estimated that 1 in 100 people have coeliac disease, though many remain undiagnosed. According to NHS guidelines, anyone diagnosed with coeliac disease should be referred to a dietitian for support in transitioning to a gluten-free lifestyle.
Support groups like Coeliac UK can provide valuable resources, including information about gluten-free products and recipes. Supermarkets now stock a wide range of gluten-free alternatives, making it easier than ever to maintain a coeliac-safe diet – simply look out for the ‘Free From’ section in your chosen supermarket.
Support is available
Coeliac disease is a serious but manageable condition. By recognising the signs and symptoms of coeliac disease, seeking proper medical testing, and adopting a gluten-free diet, you can lead a healthy and vibrant life. If you suspect you might have coeliac disease, speak to your doctor and follow NHS guidelines to get the support you need.
