Coeliac disease

What is coeliac disease?

When you have coeliac disease and eat gluten, your immune system attacks your tissues and damages your gut's lining. This means your body can't absorb nutrients properly.

Although an adverse reaction to gluten causes coeliac disease, it's not an allergy or a food intolerance – it's an autoimmune condition. This means your immune system mistakes substances found in gluten as a threat to your body and produces antibodies that attack them, causing inflammation in the lining of your gut and affecting digestion.

What causes coeliac disease?

Coeliac disease is caused by your body having an adverse reaction to gluten – a protein found in wheat, barley and rye.

Common foods containing gluten include:

• Pasta

• Cakes

• Breakfast cereals

• Most bread

• Most beers

• Some processed foods, like sauces and ready meals

Some people also find that oats can trigger their symptoms, as it's common for them to be contaminated with other grains and contain a similar protein to gluten, called avenin.

Coeliac disease is a genetically-linked condition, which means having a relative with the condition increases your risk of developing it slightly. However, the majority of people who have a family member with coeliac disease don't develop the condition themselves.

What are the symptoms of coeliac disease?

The symptoms of the disease vary widely and range from very mild to severe. Mild symptoms are often dismissed as irritable bowel syndrome (IBS) or wheat intolerance as they are very similar. 

Coeliac disease symptoms include:

• Diarrhoea

• Constipation

• Wind and bloating

• Nausea and vomiting

• Stomach pains and cramps

• Indigestion

• Tiredness

• Unexplained weight loss

• Itchy rash (dermatitis herpetiformis)

How is coeliac disease diagnosed?

If a doctor suspects you have coeliac disease, they will take a blood test to look for certain antibodies in your bloodstream. To get the best result you'll need to include gluten in your diet leading up to the test.

If these antibodies are present, you may need to have a biopsy in hospital, to confirm the diagnosis. Samples of your intestine lining will be taken using an endoscope (a thin, flexible tube with a camera at the end). Doctors will analyse the sample for signs of coeliac disease.

How is coeliac disease treated?

The main treatment for coeliac disease is to exclude all gluten from your diet. It may take some time, but this will stop the damage to your gut, allowing your symptoms to clear up.

It can be challenging to make significant changes to your diet, but the doctor will be able to help you, and there are many gluten-free alternatives available to make it easier.

If you're diagnosed with coeliac disease, you should also be referred to a dietician who will give you expert advice and ensure you're still getting a balanced diet without gluten.

Are there any other treatments for coeliac disease?

In addition to cutting out gluten, you may be offered the following:

• Vitamin and mineral supplements – these can be a good idea to ensure your body isn't deficient in any essential nutrients, especially during the first 6 months after you’re diagnosed

• Antibiotics – if you have dermatitis herpetiformis (an itchy rash), certain antibiotics can help to manage this until your body can control it

In rare cases, removing gluten from the diet doesn't treat the symptoms of coeliac disease – this is known as refractory coeliac disease. In these cases, steroid treatment can help to ease symptoms.

When should I speak to a doctor?

If you have any of the above symptoms, seek medical help sooner rather than later so that you can investigate a potential diagnosis and treatment plan.

How can Livi help?

A healthcare professional at Livi can help to talk through your symptoms and, if needed, refer you for a blood test and further medical investigation. They can also help support you and offer advice for cutting out gluten from your diet.