Coeliac disease
Also called: Celiac disease, Gluten-sensitive enteropathy
An autoimmune reaction to gluten (in wheat, barley and rye) damages the lining of the small intestine, so nutrients are poorly absorbed. A strict lifelong gluten-free diet heals the gut.
Condition-specific references are below. Individual claims and this page have not been clinically reviewed. Read about this content.
About 1 in 100 people, most undiagnosed.
What happens in the body
In people with HLA-DQ2/DQ8, gluten peptides modified by tissue transglutaminase trigger T-cell inflammation that flattens the villi.
Causes
- Immune reaction to gluten in genetically predisposed people
Risk factors
- Family history
- Type 1 diabetes and autoimmune thyroid disease
- Down syndrome
Symptoms
- Diarrhoea, bloating, wind
- Abdominal pain
- Tiredness and iron-deficiency anaemia
- Weight loss or poor growth in children
- Itchy blistering rash (dermatitis herpetiformis)
- Some people have no gut symptoms
Diagnosis — tests and examinations
- Tissue transglutaminase (tTG-IgA) antibody test while eating gluten
- Duodenal biopsies at endoscopy
Treatment
Medicines and medical treatment
- Correct deficiencies: iron, folate, vitamin D, calcium
Self-care, home remedies and lifestyle
- Strict lifelong gluten-free diet
- Dietitian support; check food labels and cross-contamination
- Bone density check
Possible complications
- Osteoporosis
- Anaemia
- Infertility
- Small-bowel lymphoma (rare)
Prevention
- No prevention; screen first-degree relatives
Outlook
Excellent on a gluten-free diet; the gut lining heals within months to years.
When to see a doctor
See a doctor for persistent gut symptoms, unexplained anaemia or tiredness. Do not start a gluten-free diet before testing.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
Related conditions
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