Coeliac Disease is commonly thought of as an allergy or intolerance to gluten. However, it is actually an autoimmune disease for which the life long treatment is a gluten free diet.
Around 1% or 1 in 100 people in the UK population have coeliac disease but only 24% of these people have been diagnosed. Why? Well, it can be tricky to diagnose as the symptoms are varied and can be misdiagnosed as as a number of illnesses including irritable bowel syndrome. Some people have no symptoms at all.
Symptoms of Coeliac Disease
Gastro-intestinal Symptoms: Bloating, abdominal cramps, nausea, wind, constipation, diarrhea.
Absorption Symptoms: Anaemia, poor absorption of micronutrients, lactose intolerance
Other Symptoms: mouth ulcers, migraines, itchy skin rash, depression and low mood
Why is it important to be diagnosed?
In celiac disease, gluten causes damage to the villi of the small intestine. These are like little fingers that poke out ready to grab and absorb food molecules. Therefore having coeliac disease can affect the absorption of nutrients from your diet leaving you at risk of nutritional deficiencies and certain diseases. For example, malabsorbing calcium can affect your bone mineral density (BMD) putting you at risk of osteoporosis. Studies have shown that low BMD can affect up to 75% of people at diagnosis with celiac disease and can be found at any age. Improvements will occur with a gluten free diet but there is still an extra requirement for calcium in the diet (1000mg/day for adults).
If you have coeliac disease and are untreated, there is an increased risk of lymphoma and small bowel cancer. Once you start on a gluten free diet the villi can regrow and the risks revert back to normal. Another good reason to be diagnosed and adhere to the diet is that untreated celiac disease can also be the cause of infertility in some people. Again, once you are following a gluten free diet, fertility levels improve.
Those with another autoimmune disease can be at higher risk of coeliac disease. There is an increased risk of type 1 diabetes and autoimmune thyroid disease. So being diagnosed and following a gluten free diet can have huge health consequences.
How to get tested:
It is crucial that you ensure that you keep eating gluten daily whilst you are being tested or it can affect the test results.
Step 1: The first test done is a blood test that looks at your levels of total IgA (antibody) levels IgA Anti-tissue Transglutaminase Antibody (TTG). A certain proportion of the population are IgA deficient so it is possible to get a false negative result, so if you still think you have celiac disease it is important to move to step 2.
Step 2: The next stage is a biopsy where a piece is taken from your intestines and looked at under the microscope to see what has happened to those villi. This may not be pleasant but it does gives a definite diagnosis.
Step 3: Treatment is to have any nutritional deficiencies corrected and to follow a life long gluten free diet.