In this blog, we will look at the following:
- What is Coeliac Disease?
- The common symptoms
- Getting diagnosed
- What is the treatment for Coeliac Disease?
- What is gluten?
- Why a gluten free diet is important?
- The difference between coeliac disease and IBS
What is Coeliac Disease?
Coeliac disease is a life-long autoimmune condition that affects the small intestine.
An autoimmune condition is where your body’s natural defence system mistakes its own healthy cells for harmful invaders and begins to attack them. In coeliac disease, the body attacks its own gut in response to eating gluten.
What are the common symptoms?
The symptoms of Coeliac disease can be very similar to other conditions such as Irritable Bowel Syndrome (IBS) or Inflammatory Bowel Disease (IBD) and can include (1):
- Bloating
- Constipation
- Diarrhoea
- Excessive wind
- Nausea
- Vomiting
- Tiredness
- Recurrent mouth ulcers
- Anaemia – which is the deficiency of iron, folic acid, and/or vitamin B12
- Bone or joint pain
- Skin issues which could be Dermatitis herpetiformis – which is an autoimmune skin condition which is linked to coeliac disease
- Depression
- Alopecia
The type of symptoms and the severity of the symptoms can vary from person to person. In fact, there are some people who will not experience any symptoms at all. It is estimated that about 50% to 90% of people remain undiagnosed because their symptoms are so mild! (2).
How is coeliac disease diagnosed?
Coeliac disease is diagnosed in two steps:
STEP 1: An initial blood test will be done to check whether there are any specific antibodies found in the blood. Antibodies are proteins that are made by the body’s immune system which help fight off harmful substances. Most people who have coeliac disease often have higher amounts of these antibodies in their blood.
STEP 2: A small sample of the gut will be taken so it can be looked at under a microscope by a medical professional. This is also known as a ‘biopsy’. It is done by passing a small tube attached to a camera (endoscope) through your mouth and into your gut. This is the most reliable method for diagnosing coeliac disease.
PLEASE NOTE: If you are being tested for coeliac disease, it is important that you continue eating gluten-containing foods so that the immune response (caused by eating gluten) will show up on the tests.
What is the treatment?
The only treatment for Coeliac disease is a lifelong, strict Gluten Free Diet.
What is gluten?
‘Gluten’ is a protein that’s naturally found in grains such as wheat, rye, and barley. It is commonly found in bread, pasta, wheat-containing cereals, biscuits, and cakes. Gluten is often used in baking as it helps to bind food together giving it structure, as well as a lovely elastic quality.
Why is it important to stick to a gluten-free diet?
Your small intestine is lined with many finger-like projections, also known as ‘villi’, which help your gut absorb important nutrients for good health. When someone with coeliac disease eats gluten and it triggers an immune response, the villi in the gut becomes damaged and begins to flatten over time. This makes it harder for the gut to absorb nutrients effectively and it can lead to nutrient deficiencies such as iron and calcium (and many more), which increase the risk of brittle bones and osteoporosis, nerve damage, anaemia (i.e., iron, folic acid, vitamin B12), some cancers, and even infertility (1,3,4).
NB: Even if you don’t have noticeable symptoms, it does not mean that it isn’t causing damage to your gut!
What is the difference between coeliac disease and IBS?
Coeliac disease and IBS can cause similar digestive-related symptoms; however, these are very different conditions.
IBS is a syndrome which mostly affects the function of the digestive system. The cause of IBS is unknown, but what we do know is that there are certain triggers such as certain foods or lifestyle issues. Ongoing IBS symptoms do not usually cause damage to the gut (NHS Inform, 2023). (5)
Coeliac disease is an autoimmune condition that can cause a variety of body-wide symptoms. If a strict gluten-free diet is not followed, the “immune response” will cause damage to the gut which can lead to further health-related problems (1).
It is possible to have Coeliac disease and IBS, but if you are newly diagnosed with Coeliac Disease, it is important to first follow a strict Gluten Free diet to give the gut a chance to heal and for symptoms to reduce. This can take a long time, commonly up to a year or more. It can be very challenging to live a gluten free life as you would also need to be aware of “hidden” sources of gluten and the possibility of cross contamination. If you are first diagnosed, it can be helpful to get advice from a registered Dietitian to get you on the right track . I can help with this and you are welcome to book a free introductory call here to discuss how I can help:
If you suspect you may have IBS or have been diagnosed with IBS as well, it will be helpful to understand what your triggers are. You can download my GUT BACK ON TRACK SYMPTOMS AND TRIGGER TRACKER HERE to help you get started to identify some of the most common triggers. Although there can be more dietary triggers for which it will be helpful to work through these with a trained Dietitian, this tracker list some of the most common food related ones.
If you are currently struggling with digestive symptoms, it is advisable to see your GP to ensure you get a proper diagnosis. There are some RED FLAG symptoms to be aware of that may not be IBS and these are:
RED FLAGS:
- Sudden change in bowel habits
- Vomiting
- Blood in your stool
- Unintentional weight loss
- Waking in the night to have a poo
- Having difficulty swallowing
Don’t ignore the red flags!
Do not self-diagnose. Always consult your GP if you notice any of the red flags. If your GP thinks that you may have coeliac disease, they will refer you to a gastroenterologist for further tests.
If you have been diagnosed with Coeliac disease and would like to discuss the Gluten free diet, then please do get in touch. You can get in touch.
Do also consider joining Coeliac UK, an independent charity for people who need to live Gluten free. Check out their website and download their amazing app where you will have on hand information on gluten free products whenever you need it.
Written by Eleanor Sinclair (Registered Dietitian) ; Reviewed and edited by Christel Lyell (Registered Dietitian)
I help people with digestive issues, get their gut back on track so they can live their lives with confidence again. If you would like to discuss how I can help, then click on this link to book a free introductory call:
REFERENCES
- Webster-Gandy, J. Madden, A. and Holdsworth, M. eds. (2020) The essential guide for the nutritional and dietary care of patients and populations: Oxford Handbook of Nutrition and Dietetics. 3rd ed. Oxford: Oxford University Press.
- Gillet, H. R. and Goddard, C. J. R. (2006) Complications of coeliac disease: are all patients at risk? Postgrad Med J, 82 (973) Nov, pp. 705-712.
- Coeliac UK (n.d.) Infertility and coeliac disease [Online] Buckinghamshire: Coeliac UK. Available from: https://www.coeliac.org.uk/information-and-support/coeliac-disease/conditions-linked-to-coeliac-disease/infertility-and-coeliac-disease/ [Accessed 1st February 2023].
- Kreutz, J. M., Adriaanse, M. P. M., van der Ploeg, E. M. C. and Vreugdenhil, A. C. E. (2020) Narrative Review: Nutrient deficiencies in adults and children with treated and untreated celiac disease. Nutrients, 12 (2) Feb, pp. 500.
- NHS Inform (2023) Irritable bowel syndrome (IBS): About IBS [Online] Scotland: NHS 24. Available from: NHSinform [Accessed 1st February 2023].
