What is coeliac disease?

We take a look at coeliac disease to explain what it is and what causes it.

Coeliac disease is an autoimmune condition where the body  has an abnormal reaction to gluten (the proteins found in wheat and related grains).

When a person with coeliac disease eats gluten the body reacts as if it’s harmful and tries to fight it by producing antibodies against it. This reaction leads to inflammation of the villi (tiny finger like structures) in the lining of the small intestine and they become swollen and flat. This flattening of the villi reduces the surface area of the bowel which drastically reduces the ability to absorb nutrients. 

What are the signs and symptoms? 

Some people experience various symptoms, while others might not have any at all. Common signs include:
  • Stomach pain or discomfort
  • Gas and/or bloating
  • Diarrhoea, or severe constipation 
  • Nausea and/or vomiting 
  • Weight loss
  • Bone and/or joint pain
  • Fatigue
  • Dizziness
  • Anaemia or other vitamin deficiencies 
  • Dermatitis herpetiformis (an itchy, blistering rash usually on the elbows, knees and buttocks).
In children, there can be a failure to thrive – developmentally, physically, and even emotionally.
According to Coeliac Australia, having a related health issues such as those listed below indicates you may need to be screened for coeliac disease: 
  • Autoimmune diseases such as type 1 diabetes or rheumatoid arthristis
  • Unexplained fertility problems
  • Liver problems
  • Early onset of brittle and weak bones (osteoporosis)
  • Nervous system problems such as neuropathy or depression
  • Oral health issues such as enamel defects or recurrent mouth ulcers.

What causes coeliac disease?

Coeliac disease is something you are born with a genetic disposition towards, and may then be triggered by something in your environment. That doesn’t mean someone will necessarily develop coeliac disease. It often runs in the family so screening is recommended if you know you have a family history of it, such as having a parent, sibling or child with coeliac disease. 

Coeliac Australia says it affects about 1 in 70 Australians, but about 80 per cent remain undiagnosed. 

How do you test for coeliac disease?

Coeliac disease can be difficult to diagnose because some of the symptoms are similar to other gastrointestinal conditions such as food intolerances and irritable bowel syndrome (IBS). This means you can’t rely on symptoms alone to diagnose it. 

If you’re worried you might have coeliac disease talk to your doctor before taking any action. It’s recommended you don’t start a gluten free diet before getting tested as it can impact on the accuracy of the test results.

Accurate testing involves two steps. First you’ll need to get a blood test which looks for an elevated level of certain antibodies in the blood. 

If the blood test shows signs of coeliac disease it’s important to follow it up with a small bowel biopsy to confirm the diagnosis. A small bowel biopsy involves a simple day procedure called a gastroscopy, which is usually performed under light sedation. Flexible equipment is passed through the mouth and down to the small intestine to take a small sample of cells from the lining. This will be examined under a microscope to determine whether damage is present.  

How do you treat coeliac disease?

There is no currently no cure for coeliac disease which is a lifelong condition. The good news is it can be managed by following a strict gluten-free diet. This allows the bowel to heal and once again absorb nutrients from food, and to avoid further damage. 

The FoodSwitch app from Bupa and The George Institute for Global Health has a handy filter to help you find out whether a food product contains gluten. It can also show you other similar products which are gluten free. Find out more at bupa.com.au/foodswitch  
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