Coeliac disease: your questions answered

Coeliac disease is a common allergy to gluten, which can trigger many different symptoms. In his latest online article, renowned consultant gastroenterologist Dr Paul Blaker offers his expert insight into this disease.

What is coeliac disease?

Coeliac disease is a type of allergy to a substance called gluten, which is a protein contained in wheat, barley, and rye. The allergy leads to inflammation in the gastrointestinal tract, usually in the upper part of the gastrointestinal spinal tract known as the small bowel.

Is it serious?

Coeliac disease can be serious if left untreated, and very rarely, it can be associated with something known as an enteropathy-associated T-cell lymphoma. However, this is exceedingly rare in the majority of patients. It gives symptoms which can affect the person's quality of life, and again, over the long term might lead to micronutrient deficiencies, which can affect the patient’s global health.

What are the early warning signs of coeliac disease?

Coeliac disease can present quite insidiously over a long period.  It might present with abdominal discomfort, bloating, loose stools or the symptoms of malabsorption, such as vitamin or micronutrient deficiencies.

How is it treated?

The mainstay of therapy for Coeliac disease is the patient starting a gluten-free diet. That means strictly withholding wheat, barley and rye from the diet. The good news about that is that once the patient is established on a gluten-free diet, the majority of patients improve and the injury to the small bowel recovers with time. This can be tracked with blood tests as well as observing whether or not patients are improving clinically.

How can people manage to have coeliac disease? Do they need to avoid specific food?

The mainstay of therapy in Coeliac disease is avoiding wheat, barley, and rye.  I think this is still difficult for patients with Coeliac disease, but is perhaps increasingly less difficult as now all foods in the UK are labelled, and so it's much easier to determine which foods might contain gluten.

There are sometimes hidden sources, and I think that there are certain areas of cross-contamination in the home, for example, sharing a toaster. You can get cross-contamination from those that are using gluten-free bread to those that are using bread with gluten. This can happen in restaurants as well. This can be a problem. But usually, if patients avoid gluten, then that should lead to the resolution of symptoms and ultimately inflammation. But it is a condition that patients have to live with lifelong, and that means lifelong dietary change.

Dr Paul Blaker is a revered consultant gastroenterologist and general physician based in Tunbridge Wells. If you would like to book a consultation with Dr Blaker you can do so today via his Top Doctors profile.