Coeliac Disease

What is coeliac disease?

Coeliac disease is a condition where your body's defence system (immune system) gets confused and attacks your own gut when you eat gluten. This damages the lining of your small bowel, which means your body can't take in nutrients from food properly.

Gluten is a protein found in wheat, barley, and rye. It's in many everyday foods like bread, pasta, cereals, cakes, and even some sauces and ready meals. Most beers contain gluten too.

What are the symptoms?

When people with coeliac disease eat gluten, they might get:

Gut symptoms:

• Runny poos (diarrhoea) that may smell very bad
• Stomach pain
• Feeling bloated and windy
• Heartburn
• Hard poos (constipation)

Other symptoms:

• Feeling very tired because your body isn't getting enough nutrients
• Losing weight without trying
• An itchy skin rash
• Problems getting pregnant
• Nerve damage causing tingling or numbness

Children with coeliac disease might not grow as expected and may go through puberty later than usual.

What causes it?

Coeliac disease is what doctors call an "autoimmune condition". This means your immune system mistakes something harmless (gluten) for something dangerous and attacks it. When this happens, it damages your gut lining.

We don't know exactly why some people develop this condition. It seems to be partly due to the genes you inherit from your family and partly due to things in your environment.

Who gets coeliac disease?

At least 1 in every 100 people in the UK has coeliac disease, but many don't know they have it because their symptoms are mild. Women are more likely to be diagnosed than men.

You're more at risk if:

• Someone in your close family has coeliac disease
• You have type 1 diabetes
• You have thyroid problems
• You have Down's syndrome or Turner syndrome

How is it treated?

There's no cure for coeliac disease, but the good news is that following a strict gluten-free diet should control your symptoms and prevent serious problems later on.

Even if your symptoms are mild, it's important to avoid gluten completely. Continuing to eat gluten can lead to serious complications like weak bones, anaemia, and in rare cases, certain types of cancer.

The range of gluten-free foods has improved hugely in recent years, so you can still eat a healthy, varied diet.

When to speak to your GP

Speak to your GP if you have:

• Ongoing stomach problems like diarrhoea, bloating, or stomach pain
• Unexplained weight loss
• Extreme tiredness that doesn't improve with rest
• Any combination of the symptoms mentioned above

Seek urgent medical attention if you have:

• Severe stomach pain
• Blood in your poos
• Persistent vomiting

If you have a close family member with coeliac disease, ask your GP about getting tested even if you don't have symptoms.

Getting support

Coeliac UK is a charity that helps people with this condition. You can call their helpline on 0333 332 2033 (Monday to Friday, 10am to 4pm) for advice about gluten-free living and local support groups.

Remember, with the right diet and support, most people with coeliac disease can live completely normal, healthy lives.

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Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.