Coeliac disease (pronounced seel-ee-ak and sometimes spelt celiac) is a autoimmune disease. When people with the disease consume gluten, a protein found in wheat, rye, barley and oats, the immune system mistakenly recognises it as danger and starts attacking the body. This reaction causes inflammatation and damage to the small bowel. Specifically, the villi (small hair like projections) which line our intestines and 'catch' the nutrients from our food, become inflammed and flattened. This is known as villous atrophy and can lead to nutrient deficiencies, and associated complications.
The symptoms of the disease vary widely, however common complaints include abdominal pain, flatulence, bloating, diarrhoea and vomiting, fatigue and weight loss. Some individuals experience extreme symptoms which may even require hospitalisation, while others are 'asymptomatic' experiencing no external symptoms. Many people lie between these extremes. Importantly, regardless of your external reaction, the same damage is being done internally to the woman with a slight stomach ache and the young boy whose rushed to emergency. For a coeliac, no amount of gluten is safe, ever.
If any of the following symptoms or conditions are present, individuals are at greater risk of developing coeliac disease:
- iron deficiency
- gastrointestinal symptoms
- autoimmune diseases, such as type 1 diabetes or hashimoto's disease
- weight loss
- infertility or recurrent miscarriage
- a family history of coeliac disease.
We are born with a genetic predisposition to develop coeliac disease, with virtually all coeliac's possesing either the HLA DQ2 or the HLADQ8 gene, or both. Despite being born with the genes, the disease is often activated or triggered by other genes or environmental factors at some stage throughout a person's life, from infancy to later life. It's important to note only one in 30 people with the gene will develop the condition.
What if I suspect I've got coeliac disease, but just keep eating gluten?
Untreated, coeliac disease can lead to chronic ill health, osteoporosis, infertility, depression, liver disease, miscarriage and various cancers, namely bowel. A gluten free diet is a simple way to avoid these awful conditions.
How do I get diagnosed?
If you suspect you may have coeliac disease, the most important thing to do is continue eating gluten.
Now I understand this may seem counter-intutive, I mean why would I eat something that makes me feel sick? But if you stop eating gluten, you will either be refused the the diagnostic tests until you've reintroduced gluten for at least four weeks, or risk receiving inaccurate results. And trust me, getting back on gluten after having a break is not nice, as often the longer you don't eat it, the worse your reaction becomes.
Next, of course, visit your doctor. He or she will recommend blood tests which measure key markers of the disease. If your results are positive (or borderline), you will be referred to a gastroenterologist. They may also test for the presence of either coeliac gene in the blood test or via a simple cheek scrape.
From there, the gastro will decide whether or not to perform a endoscopy or colonoscopy to confirm the presence of coeliac disease. This is a simple day procedure in which several samples (biopsies) of the small bowel are taken.
If coeliac disease is confirmed, the best course of action is to visit a dietitian. Initially, it can seem extremely confronting, but with their guidance you'll be able to navigate the gluten free world with peace of mind and soon realise it's not too bad!
You may also consider signing up with your local branch of the Coeliac Society who send member's helpful information and discounts on certain gluten free products.
Searching Facebook for support groups and joining up can also be extremely helpful as you can chat with and ask questions to a group of understanding individuals. This disease can be frustrating at times, so sometimes it's just nice to vent to someone who gets it!