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About Coeliacs Disease

What is it?

It is a life-long inflammatory condition of the gastrointestinal tract. This is caused by gluten, a protein in wheat, and similar proteins in rye, barley and oats.

What effect does gluten have on the body?

In a Coeliac, gluten damages the lining of the small intestine which greatly reduces the ability of the gut to absorb adequate nutrients from food. Wasting can occur, leading to severe illness resembling malnutrition.

Is it only a children's condition?

No - in the 1950s it was thought to be almost exclusively a childhood condition but now it is recognized that many more adults than children are diagnosed. Coeliac symptoms can manifest themselves at any age and, according to Celiac UK statistics, most celiacs are diagnosed when aged between 30 and 45 years. Recent figures even show more over-60s than under-16s being diagnosed in a year.

What are the symptoms?

Coeliac patients may be acutely and severely ill with weight loss, vomiting and diarrhoea or they may have chronic almost trivial symptoms such as tiredness, lethargy and breathlessness. Usual symptoms would be somewhere between these extremes. Adults may have a history of abdominal or intestinal upsets, or they may suddenly develop the condition at any time. Anaemia, abdominal discomfort, mouth ulcers and weight loss are common features. A Coeliac baby would be fit and well until after the introduction of gluten-containing solids. Then the baby would develop typical pale, bulky, offensive-smelling stools, become miserable and lethargic and generally fail to thrive. All the symptoms described can be characteristic of other medical conditions, so people should not jump to conclusions but should seek proper medical advice. They should not treat themselves with a gluten-free diet before seeking medical help. Some people are diagnosed as Coeliac without having obvious symptoms. For example, the condition may be picked up when relatives of a Coeliac are being studied.

How is the condition diagnosed?

It is nearly always diagnosed in the outpatients' department of a hospital, by a gastroenterologist. An intestinal biopsy should be obtained, usually under mild sedation.

What is the treatment?

The only treatment necessary to return the intestine to normal is a strict gluten-free diet. Sometimes vitamin or mineral supplements may be required to start with. The hospital consultant will know from tests what the patient needs, and supplements should NOT be taken without medical supervision. To avoid serious complications of the condition, a strict gluten-free diet is necessary for life.

Do many people have Coeliac disease?

Coeliac disease used to be rare, but more and more doctors are beginning to recognize the disorder in their patients. The average incidence in the United Kingdom is 1 in 100 people. It is also known that the condition runs in families.
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