Dr Chris Steele provides background information about Coeliac disease, caused by intolerance to gluten.

All about Coeliac disease

Coeliac disease is a life-long autoimmune disease caused by intolerance to gluten, which causes an inflammation of the small intestine. Damage to the small intestine will occur each time gluten is consumed.

Gluten is a protein found in wheat, rye and barley.

1 in 100 people are estimated to suffer from coeliac disease in the UK; however, according to a recent study only 1 person in 8 have been diagnosed.

If left untreated, it can ultimately lead to malnutrition, osteoporosis and bowel cancer.

It is a genetic disease, and studies show that if a family member has coeliac disease there is an increased risk of 1 in 10 to other family members.

Symptoms depend on the individual, but can include: weight loss (although not in all cases), vomiting, diarrhoea, constipation, tiredness, lethargy and breathlessness. Anaemia, abdominal discomfort and mouth ulcers are also common symptoms. People have also been known to suffer from neurological problems (such as ataxia), migraines and other autoimmune conditions (for example Type 1 Diabetes). The disease when undiagnosed can also lead to problems with infertility.

Children with coeliac disease may exhibit behavioural problems, irritability, diarrhoea and classic gut problems; they may also fail to meet normal growth targets.

Although people are born with the genetic predisposition to the disease, the symptoms can occur at any stage in life; they can be triggered or exacerbated by times of stress, viruses or life-changing events.

Initial screening for the disease is a blood test taken by a GP. The next step is referral gastroenterologist (gut specialist doctor) for an endoscopy of the upper gastrointestinal tract and a biopsy of the small intestine. Small samples of gut lining are examined for the type of gut damage consistent with coeliac disease.

The only way to manage coeliac disease is by following a strict gluten-free diet. This involves eliminating anything which contains gluten from your diet. Following a gluten-free diet allows the gut lining to heal and symptoms should resolve.

In addition to wheat, rye and barley, gluten containing cereals may be used as an ingredient in processed foods such as baked beans, fish fingers, mayonnaise and soy sauce. Some people with coeliac disease are also sensitive to oats.

People diagnosed with coeliac disease can be prescribed an NHS prescription for basic food including bread, pasta and flour mixes.

Due to current funding considerations within the NHS, some PCTs have sought to restrict or stop prescriptions for gluten-free foods. Due to the comparatively high cost of gluten-free food for many people on lower incomes the prescriptions are essential to ensure they maintain a healthy diet. Coeliac UK has opposed measures to restrict prescriptions where it affects staple foods.

Further Information
You can visit www.coeliac.org.uk to get more information about Coeliac disease.


This content was created on Mon 31 July 2006

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