Coeliac Disease

The digestive system is composed of organs that are involved in the digestion of food and absorption of vital nutrients needed for growth and good health. The small intestine is one of the most important parts of the digestive system, and is lined by millions of microscopic, finger-like projections known as villi. These are involved in the absorption of minerals, vitamins, electrolytes and fluids in the body.

Coeliac disease is an autoimmune disease in which the body’s immune system acts against gluten (protein found in wheat, rye and barley) causing inflammation of the small intestine, and damage or destruction of the villi. The body’s capacity to absorb food soon declines leading to the risk of malnutrition and malabsorption.

Causes

The exact cause of coeliac disease remains unknown but one of the main causes is the destruction of the villi by the body’s own immune system, which results in malnourishment of the body. It has been seen that people having a family history of this disease have more chance of getting this disorder. It is more common in Caucasians, Europeans and women. People suffering from autoimmune disorders like rheumatoid arthritis, systemic lupus erythematosus, Sjogren’s syndrome, Addison’s disease, and those with Down syndrome are more susceptible to coeliac disease. Similarly, disease conditions, such as intestinal cancer or lymphoma, lactose intolerance, and people suffering from thyroid disease or type 1 diabetes, are more likely to develop this disease.

Symptoms

The major symptoms related to coeliac disease may include:

• Abdominal pain, gas, bloating, or indigestion
• Constipation or diarrhoea
• Reduced appetite
• Lactose intolerance
• Nausea and vomiting
• Foul smelling stools
• Unexplained weight loss
• Bruising easily
• Fatigue
• Hair loss and itchy skin
• Ulcers in the mouth
• Joint pain or muscles cramps
• Unexplained short height
• Seizures
• Tingling or numbness in hands and feet
• Missed menstrual period

Coeliac disease in children may produce symptoms like:

• Delay in puberty
• Irritable and fussy behaviour
• Diarrhoea, constipation
• Fatty or foul-smelling stools
• Nausea, or vomiting
• Defects in the tooth enamel in some, resulting in changes in teeth colour
• Poor gain in weight and height
• Symptoms may vary from person to person, making diagnosis challenging.

Diagnosis

If coeliac disease is suspected, your doctor will assess your medical history and conduct a thorough physical examination. Your doctor may also order certain blood tests to estimate levels of certain proteins and antibodies (immune response) to gluten. If your results are positive, a biopsy of the small intestine is performed, where a sample of the small intestinal tissue is removed through a thin long tube called an endoscope.

Treatment

Treatment for coeliac disease is aimed at alleviating the symptoms, as there is no cure for the disease. Treatment usually involves a life-time diet of gluten-free foods. For this, you should read food and medication labels beforehand to prevent any gluten-induced immune reaction. You may also be prescribed vitamin and mineral supplements to correct deficiencies or corticosteroids to suppress certain immune reactions.

Maintaining a gluten-free diet may be difficult as most foods contain gluten, but you will be able to adapt to a more suitable diet over time.