About coeliac disease

Coeliac disease is an autoimmune condition that occurs in people who are sensitive to a protein called gluten. In the UK alone, coeliac disease affects an estimated 1 in every 100 people.

Here, Dr Anthony Lerman, renowned consultant gastroenterologist based in London, provides an expert insight into coeliac disease.

How does coeliac disease occur?

Coeliac disease is a specific type of immune reaction to certain grains (wheat, barley and rye). These grains are closely related to each other, and all share a similar protein called gluten. Gluten itself is predominantly made up of two different types of proteins, one of which is called gliadin.

Most proteins that we eat are broken down into their constituent parts (into their amino acids) in the gut. Gliadin, however, is difficult to digest and isn’t fully broken down.

When gliadin comes into contact with the cells in the gut in susceptible people, it triggers an immune response in the body, as if it were a foreign invader like a virus rather than a protein. This response triggers a cascade of immunological reactions which cause coeliac disease.

Coeliac disease can occur at any age, and it is unknown why it occurs in susceptible people at a particular age. There are many different types of immune responses; coeliac disease is only a specific type of immune response to a specific protein and a specific food type.

What are the early warning signs of coeliac disease?

Many people who have coeliac disease don’t know that they have it. Coeliac disease can be a silent disease, but sometimes it can cause symptoms.

Gut symptoms include diarrhoea, unexpected weight loss, abdominal pain, abdominal distension, bloating, and constipation. Non-gut manifestations include a particular type of rash and mouth ulcers. Sometimes, people who have coeliac disease have numb nerve endings and problems with co-ordination, but this is much rarer.

In some occasions, coeliac disease manifests through blood tests. Routine blood tests would show, for example, a deficiency in iron, a deficiency in certain vitamins, or an abnormal liver function.

Why should I get tested for coeliac disease?

You should get tested for coeliac disease if you have long-standing gastrointestinal upset.

The problem with coeliac disease is that none of its symptoms or features are specific for coeliac disease. The symptoms of coeliac disease can be caused by many other gastrointestinal or even non-gastrointestinal diseases, and so coeliac testing is typically ordered as part of a panel of tests.

What foods should you avoid if you have coeliac disease?

The treatment for coeliac disease is the avoidance of the triggers, which are wheat, barley, and rye. This is the mainstay of the treatment for coeliac disease.

If you require expert diagnosis and treatment for coeliac disease, don’t hesitate to book an appointment with Dr Anthony Lerman via his Top Doctors profile today.