Coeliac Disease
Coeliac disease is a condition that affects about 1 in every 100 people in Ireland. It is caused by an intolerance to gluten, a protein found in a number of different foods. It is a lifelong condition: once you are diagnosed, you will have it for life. Coeliac disease is often confused with Irritable Bowel Syndrome so it is important to always talk to your GP when you have any bowel symptoms and to rule out coeliac disease as a cause.
What is Coeliac Disease?
At its most basic, coeliac disease as a severe intolerance to gluten, but there is a little bit more to it than just that. People with coeliac disease react badly to gluten, a protein found in wheat, rye and barley. Some coeliacs also react to oats. When someone with coeliac disease eats gluten, the gluten damages the lining of their bowel.
Our bowels are lined with small, finger-like projections called villi. These stick out into food as it passes, and helps our bodies to absorb it. If someone is coeliac, then the gluten in food damages these villi. This makes it harder for coeliacs to digest and absorb their food.
What symptoms can I have?
Coeliac disease has a number of symptoms and you can have them all or even have none and still have the disease. Symptoms include:
Diarrhoea
Constipation
Bloating
Chronic tiredness
Anaemia
Chronic mouth ulcers
Infertility & recurrent miscarriage
Moodiness & depression
Indigestion
Bone pain
Itchy rash called Dermatitis Herpetiformis
Each person with coeliac disease can have different symptoms and symptoms can also seem to come and go.
Testing for Coeliac Disease
If you think you might have coeliac disease, it is very important to talk to your GP. Never self-diagnose and avoid using alternative testing. Your symptoms may be caused by something else and your GP will be able to check. Your GP will use a blood test and may send you for an endoscope as well.
Remember: you need to be eating gluten for at least two weeks before you have a test for coeliac disease otherwise your test will come back negative. If you are avoiding gluten, the test will be negative even if you are coeliac. If you are already on a gluten free diet tell your doctor or dietitian before you are tested.
Gluten Free Diet
The treatment for coeliac disease is a strict gluten-free diet. It is very important that someone who is coeliac avoids all gluten all of the time. Some coeliacs will feel sick straightaway if they eat gluten, but for others it can take a few years to feel unwell – but they still have the same damage to their bowels. Avoiding gluten sounds easy but it can take a lot of work and support before you manage to remove all gluten from your diet. That is why it is recommended that you see a qualified dietitian once you are diagnosed.
What are the long-term problems?
Coeliacs who do not follow a strict gluten free diet are more likely to have problems with osteoporosis, anaemia and fertility as well as feel more tired. There is also a slight increased risk of a particular kind of bowel cancer. However, if you follow a strict gluten free diet, your risk is exactly the same as someone who is not coeliac.
Managing Coeliac Disease and a gluten free diet
A strict gluten free diet is a lot more difficult than it might sound. Seeing a dietitian when you are diagnosed and then once a year after that is important in staying healthy with coeliac disease. Many coeliacs miss out on fibre, B vitamins and need special advice around calcium and iron. Weight can also become an issue for some people once they are diagnosed. It is recommended to speak to a registered dietitian to discuss how you can cut out gluten whilst maintaining a healthy balanced diet with all the nutrients you need for health now and in the future.