Coeliac disease is a serious condition that affects the digestive system. It is caused by an abnormal immune response to gluten, a protein found in wheat, barley, rye, and some oats. When people with coeliac disease eat gluten, their immune system attacks the lining of their small intestine, causing inflammation and damage. This prevents them from absorbing nutrients properly and can lead to various health problems.

Coeliac disease is not a food allergy or intolerance. It is a lifelong autoimmune disorder that requires strict adherence to a gluten-free diet. There is no cure for coeliac disease, but following a gluten-free diet can help manage the symptoms and prevent complications.

Symptoms of coeliac disease

Coeliac disease can affect people of any age, gender, or ethnicity. However, it is more common in people who have a family history of the condition or other autoimmune diseases. The symptoms of coeliac disease vary from person to person and can range from mild to severe. Some people may not have any symptoms at all, while others may experience:

• Digestive problems, such as diarrhoea, constipation, bloating, gas, stomach pain, nausea, vomiting, and indigestion
• Fatigue, weakness, and anaemia (low red blood cell count)
• Weight loss or poor weight gain
• Growth problems and delayed puberty in children
• Skin rashes, such as dermatitis herpetiformis (itchy blisters on the elbows, knees, buttocks, and face)
• Mouth ulcers and dental enamel defects
• Bone and joint pain and osteoporosis (weak bones)
• Neurological problems, such as headaches, numbness, tingling, seizures, and ataxia (loss of balance and coordination)
• Reproductive problems, such as infertility, miscarriage, and low birth weight
• Mood changes, such as depression, anxiety, and irritability

Diagnosis of coeliac disease

If you suspect that you or your child may have coeliac disease, you should consult your GP as soon as possible. Do not start a gluten-free diet before getting tested, as this can affect the accuracy of the diagnosis. Your GP will ask you about your symptoms, medical history, and family history. They will also perform a blood test to check for antibodies that are produced by your immune system when you eat gluten. If the blood test is positive or inconclusive, you will be referred to a gastroenterologist (a specialist in digestive disorders) for further tests. The gastroenterologist will perform an endoscopy (a procedure that involves inserting a thin tube with a camera into your mouth and down your throat) to take a biopsy (a small sample of tissue) from your small intestine. The biopsy will be examined under a microscope to look for signs of damage caused by coeliac disease.

In my case, I had a gastroscopy and a colonoscopy on the same day, which took about an hour altogether. The reason for the colonoscopy was that, given the symptoms I had presented with to my GP she was concerned that I might have some form of bowel cancer. Thankfully that turned out not to be the case.

Treatment of coeliac disease

The only treatment for coeliac disease is a strict gluten-free diet for life. This means avoiding all foods that contain wheat, barley, rye, and sometimes oats. You will also need to check the labels of processed foods for hidden sources of gluten, such as malt extract, modified starch, soy sauce, and some flavourings and thickeners. You may also need to avoid cross-contamination from utensils, cookware, or surfaces that have been in contact with gluten.

Eating gluten-free can help heal the damage to your small intestine and improve your symptoms. However, it can also be challenging and require careful planning and guidance. You may benefit from seeing a dietitian (a specialist in nutrition) who can help you plan a balanced and varied gluten-free diet that meets your nutritional needs. You may also need to take supplements of vitamins and minerals that you may be lacking due to malabsorption.

Living with coeliac disease

Coeliac disease is a lifelong condition that requires constant vigilance and adaptation. It can affect your physical health as well as your emotional and social well-being. You may face challenges such as coping with symptoms, adjusting to dietary changes, managing complications, finding support from others who understand your condition.

However, with proper diagnosis and treatment, you can live a healthy and fulfilling life with coeliac disease. You can find information and support from various sources such as:

• Coeliac UK: A charity that provides advice, resources, recipes, events, and campaigns for people with coeliac disease
• NHS: The national health service that provides information on coeliac disease diagnosis
• Your GP: Your primary care provider who can monitor your condition, prescribe medication if needed, refer you to specialists if needed, etc.
• Your gastroenterologist: Your specialist who can perform tests, confirm diagnosis, provide treatment options, etc.
• Your dietitian: Your specialist who can help you plan a gluten-free diet, advise you on nutrition, etc.

Coeliac disease is a serious condition that affects the digestive system. It is caused by an abnormal immune response to gluten, a protein found in wheat, barley, rye, and some oats. The only treatment for coeliac disease is a strict gluten-free diet for life. Eating gluten-free can help heal the damage to your small intestine and improve your symptoms. However, it can also be challenging and require careful planning and guidance. You can find information and support from various sources such as Coeliac UK, NHS, your GP, your gastroenterologist, and your dietitian. By following their advice, you can live a healthy and fulfilling life with coeliac disease.