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Coeliac disease

Coeliac disease is caused when the gut has an adverse reaction to gluten, causing a range of tummy problems, like cramps, bloating, constipation and diarrhoea. Read more about the symptoms and how to treat them.

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 an adverse reaction to gluten, a protein found in wheat, barley and rye.

Any food that contains these will contain gluten. For example:

  • Pasta

  • Cakes

  • Breakfast cereals

  • Most bread

  • Most beers

  • Some processed foods, like sauces and ready meals

Coeliac disease is a genetically linked condition, so having a relative with the condition increases your risk of developing it, but the risk is low. The majority of people who have a family member with coeliac disease don't develop the condition themselves.

Coeliac disease symptoms

Symptoms 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. Talk to the doctor if you're experiencing any of the symptoms below.

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)

Coeliac disease diagnosis

If the doctor suspects you have coeliac disease, they will take a blood test to look for certain antibodies that are usually in your bloodstream if you have the condition. 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.

Coeliac disease treatment

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.

Cutting out gluten includes any food that contains wheat, barley and rye, like most breads, pasta, cereals, biscuits, cakes and pastry products. Some people also find that oats can trigger their symptoms. It's common for them to be contaminated with other grains and contain a similar protein to gluten, called avenin.

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 readily 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.

Other treatment 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 six months

  • 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.

Coeliac disease complications

If you're diagnosed with coeliac disease it's important not to eat any gluten – even small amounts can make unpleasant symptoms reappear.

If you continue to consume gluten regularly, you could be putting yourself at higher risk of developing osteoporosis or cancer later on.

Other coeliac disease complications include deficiencies in certain vitamins and minerals, including iron deficiency anaemia and vitamin B12 and folate deficiency anaemia.

Malnutrition can be another problem, making it harder for your body to recover from wounds and infections and causing severe fatigue.

Reviewed by:

Dr Rhianna McClymont

Lead GP at Livi

Last updated: