Coeliac disease is an autoimmune condition where you react to eating gluten. Gluten provokes an immune response, causing damage to the bowel and causing tummy pain, bloating and other symptoms. Along with ongoing symptoms, if you keep eating gluten, this can have long-term implications such as anaemia and osteoporosis as you will have difficulty absorbing essential nutrients.
Gluten is found in wheat, rye and barley. These are the basis of pasta, bread, pastries, biscuits, beer, couscous, breakfast cereal and it can be used as a thickening or coating agent in many sauces, soups or ready meals. Oat products may also cause symptoms to flare for some people. Gluten causes stomach pain, bloating, excessive wind and diarrhoea. You may also feel very tired and be losing weight. But these symptoms can have lots of causes, so it’s important to get checked out by your doctor. A rash may develop in coeliac disease, but it’s not common. It’s red, itchy and can blister, and appears on the elbows, knees, buttocks or scalp. Coeliac disease in children can cause similar abdominal symptoms, along with vomiting and pale stools. They may not be growing as quickly as expected or the start of puberty may be delayed. These are all reasons to take your child to their doctor.
Coeliac disease is common: it affects about 1 in 100 people in the UK. Coeliac disease can start at any age and – like most autoimmune diseases – it's not known exactly why it occurs. Females are more likely to suffer, and it can run in families. It’s also more likely with certain other autoimmune conditions, such as Type 1 diabetes.
If you or your child have symptoms of coeliac disease, you should book a routine appointment with your doctor. Keep a food and symptom diary to take along to your consultation. You should not try cutting out gluten from your diet until after you have had a diagnosis, as it makes tests less accurate. The doctor will ask you about your symptoms, any other conditions and relevant conditions that run in your family. The doctor may examine your tummy and any rashes and they are likely to order blood tests. There's a blood test specifically for coeliac disease – if this is positive, you will be referred to a specialist, a gastroenterologist, who will confirm the diagnosis. They will use a flexible camera from the mouth to pass into the gut (an endoscopy or gastroscopy), and they can take a tissue sample from the gut lining. This is less scary than it sounds. If this confirms coeliac disease, you will be offered further information and support, including a dietician’s advice on following a gluten-free diet.
Look out for the gluten-free label for foods guaranteed to contain no gluten, and you may find gluten alternatives such as wheat-free bread and flour. Many supermarkets have an entire aisle devoted to gluten-free foods. Supplements are also available to boost your vitamin B stores or fibre needs, and to replace calcium and vitamin D.