Is it coeliac disease or something else?

Is it coeliac disease or something else?

Coeliac disease affects 1 in 100 people in the UK. Despite growing awareness, there still remains a lot of confusion about the nature of the disease and how it differs from other common gut conditions, like IBS and gluten intolerance. 

 

So what is coeliac disease, and how do you know if you have it?

Coeliac disease is an autoimmune condition where the immune system (the body’s defence mechanism) mistakenly attacks healthy tissue. In coeliac disease, the immune system responds abnormally to a subclass of proteins (called gliadin) found in gluten. Gluten is present in wheat, rye, barley, and oats*.

 

What are the symptoms?

The symptoms of coeliac disease result from heightened inflammation in both the gut, and throughout the whole body (systemic inflammation). In the gut, inflammation damages the small, finger-like projections that line the small intestine, called villi. In coeliac disease, the villi become shortened and eventually flatten out, resulting in poor absorption of nutrients, diarrhoea, and weight loss. Abdominal pain, bloating, food intolerances, and constipation are also common in coeliac disease.

Aside from digestive symptoms, inflammation associated with coeliac disease can result in a number of problems affecting the whole body. This is why coeliac disease is considered a whole-body (multi-system) disease. Symptoms vary between individuals, but can include:

  • Iron deficiency anaemia
  • Low bone mineral density (osteoporosis)
  • Itchy skin rashes (dermatitis herpetiformis)
  • Defects in the enamel of the teeth
  • Chronic fatigue
  • Joint pain/aching
  • Severe or persistent mouth ulcers
  • Poor growth
  • Delayed puberty
  • Migraine headaches
  • Depression or anxiety
  • Other autoimmune conditions, like overactive or underactive thyroid
  • Long-term increased risk of cancers of the small intestine and oesophagus

It’s not entirely clear what causes coeliac disease, but it’s thought to be a combination of genetics (coeliac disease tends to cluster in families) and environmental triggers (e.g. exposure to gluten).

 

What’s the difference between IBS and coeliac disease?

This is an important question as many of the symptoms of IBS overlap with coeliac disease – including changes in bowel movements, stomach pain/cramps, weight loss, food intolerances, and fatigue. In fact, research shows some people with coeliac disease are sometimes misdiagnosed with IBS.

Despite overlapping symptoms, the nature of the conditions are very different. Unlike coeliac disease, IBS is not an autoimmune condition and does not share the same long-term implications on systemic health. While symptoms of IBS are largely (but not always) isolated to the gut, coeliac disease can have whole-body effects.

 

How do I get tested for coeliac disease?

If you’re experiencing any of the symptoms above or have close family members with coeliac disease, it’s really important to get tested.

 

1. Blood Test

To get tested, your GP will take a blood sample and test it for antibodies usually present in the bloodstream of people with coeliac disease. However, sometimes these antibodies show up in people without coeliac disease.

 

2. Gut Biopsy

If coeliac disease antibodies are found in your blood, your GP will refer you for a biopsy of your gut. This will confirm the diagnosis.

 

During the testing process, it’s important that you consume sufficient gluten in your diet so that the antibodies can be detected in the blood test. You should aim to consume 2-3 servings of gluten a day (one serving = 2 slices white bread). Visit the NHS website here for more details. 

 

Long-term management of coeliac disease

The only treatment currently available is a strict, life-long adherence to a gluten-free diet. Unfortunately, many gluten-free products are lower in important nutrients including dietary fibre. In fact, many individuals with coeliac disease fail to meet the 30g recommended daily intake, and are more prone to ongoing digestive symptoms, like constipation, bloating, and gas. One of the easiest ways to promote long-term gut health is to use a diverse fibre supplement. To understand which fibre mix is right for you, take myota's 2-min quiz

 

To celebrate Coeliac Disease Awareness Week (May 9th - 13th), we'll be sharing more blog posts on the role of fibre in coeliac disease, and what to do after gluten exposure "glutening". Stay tuned.

 

*Most people with coeliac disease can eat gluten free oats. For more advice, visit Coeliac UK.