Coeliac disease
Coeliac disease is an autoimmune disorder, though it is often mistakenly believed to be a food intolerance or allergy. It affects roughly 1 in 100 people in the UK, though about 70% do not know they have this condition. Contact our clinic if you experience diarrhoea, abdominal pain, or any other symptoms of this condition. You can learn more about these below.
Overview | Our clinic | Symptoms | Causes | Diagnosis | Treatment | Diet | Complications | Video FAQs | FAQs
Our coeliac disease clinic
At Digestive Health UK, our one-stop clinic provides a range of tests in one day to look for signs of this autoimmune disorder. By offering all tests in one day, we can limit the time you need to eat gluten to create the antibodies that help confirm our diagnosis. We call this process the gluten challenge.
Treatment at our clinic involves nutritional counselling with an expert dietitian to ensure you have the necessary knowledge to follow a nutritious, varied diet without gluten. We also work with psychologists, so you can access emotional support, as we know how difficult it can be to manage a chronic condition.
What is coeliac disease?
Coeliac disease is a condition that causes your immune system to react negatively to proteins occurring in gluten. Many common foods contain gluten in the form of wheat, spelt, barley or rye, such as bread, biscuits, cakes, pasta and breakfast cereals.
This chronic autoimmune disorder causes your immune system to attack the tissues in the lining of your small intestine, which prevents it from working effectively. As a result, you experience malabsorption (problems absorbing some nutrients).
As many people do not know they have this condition, there is a lot of misinformation and who can get it and its symptoms. We discuss the misconceptions surrounding it in our blog: Common myths about coeliac disease.
Symptoms
Your symptoms may be mild or severe, and they occur due to intestinal lining damage. As the symptoms vary enormously, it may go undiagnosed for a long time or be confused with other conditions like irritable bowel syndrome (IBS).
Many people with this condition experience diarrhoea, constipation, bloating, and abdominal pain. Some people have neurological (nerve) problems, such as poor balance and tingling in the hands and feet.
You may also experience:
- Cold hands
- Mouth ulcers
- Flatulence (wind)
- Tiredness (fatigue)
- Feeling or being sick
- Iron deficiency anaemia
- Unintended or sudden weight loss
- Vitamin B12 or folic acid deficiency
Between 10% and 15% of people with this condition develop a rash called dermatitis herpetiformis (DH). It typically causes an itchy, blistering rash across your scalp, elbows, torso, knees, or bottom.
Causes
It is not entirely clear why there is an abnormal immune system reaction to gluten in people with this condition. Experts are researching it further to improve our understanding of the causes, though there’s a known genetic component.
Research has identified mutations to the human leukocyte antigen (HLA) DQ genes that may be inherited. However, some people have these and do not develop coeliac disease.
Risk factors
Close family history is not the only factor that increases your risk of this condition. People with autoimmune thyroid disease, type 1 diabetes, Down’s syndrome or Turner syndrome have a higher risk too.
You may also have a higher risk if you have Addison’s disease, microscopic colitis, or inflammatory bowel disease (IBD).
Diagnosis
If you experience symptoms of this condition, you should speak to your doctor, who may recommend a referral to a gastroenterologist (digestive health specialist). Our specialist will discuss your symptoms with you, such as how often you have them and their severity. We will also review your medical history to identify possible causes of your symptoms.
Testing
If we suspect coeliac disease, we will recommend a blood test to look for antibodies that suggest a reaction to gluten. Before your blood test, you must keep eating products containing gluten. Otherwise, your body won’t produce the antibodies, and you may get an inaccurate result. You could still have this condition even if you don’t have the antibodies.
To help confirm your diagnosis, we may perform an endoscopy with a biopsy. An endoscopy uses an endoscope, a thin, flexible tube with a camera attached, to investigate your upper digestive tract. We can use the endoscope to collect the biopsy, a small tissue sample that a lab can examine. You shouldn’t feel any pain during your endoscopy, as we use a local anaesthetic to numb the area and a sedative to relax you or make you sleep.
Treatment
After we diagnose your condition, we can form a tailored treatment plan. We may perform additional tests to discover if you have any complications, such as low iron levels.
To treat coeliac disease, you should adopt a gluten-free diet. You may need to take nutritional supplements to address nutrient deficiencies.
If you have DH, you may need to take medication such as dapsone. The rash could return if you stop taking dapsone before the gluten-free diet has taken effect.
If you still experience symptoms after following a long-term gluten-free diet, you may have a rare form of this condition: refractory coeliac disease. We may recommend steroid or immunosuppressant medication to protect your small intestine from your immune system.
If any healthcare professional prescribes a new medication, tell them you must avoid gluten. Some medicines, though not many, contain gluten. Paracetamol has very low levels of gluten, but many people with this condition can take it without side effects.
Diet
On a diet for coeliac disease, avoid bread, pasta, cereals, cakes, biscuits, and pies. Some sauces and gravies may contain gluten too. Many grocery stores sell gluten-free versions of all of these, which are made with alternative flours in a contaminant-free environment.
While it can feel quite limiting when you need to adapt your diet, there are many foods that you may still be able to eat. Unless you have any other diet restrictions, you should be able to eat most dairy products, meat, fish, rice, lentils, potatoes, fruits and vegetables. Some flours are also naturally gluten-free. These are rice, corn, soy and potato flour.
If you’re unsure whether a product contains gluten, check the label for the ingredients or a gluten-free symbol. It will likely look the same or a variation of the logos shown here:
Complications
Without treatment, people with this condition may develop other disorders or complications. It can lead to osteoporosis or bone loss, lactose intolerance, infertility, miscarriages, and migraines. Your risk of certain types of heart disease and some cancers can increase too.
Coeliac disease FAQs
Book an appointment
Our world-renowned specialists offer expert diagnostics. Together, we’ll create a personalised treatment plan and provide compassionate support to empower you with a gluten-free lifestyle that enhances your well-being.
Book an appointment today to discover the cause of your symptoms and take control of your digestive health.
Frequently asked questions
Tests
Treatments / Symptom Management
Gluten-free diet