DIAGNOSING & MANAGING COELIAC DISEASE
At LDC, our private doctors are not shy when it comes to discussing symptoms of conditions that patients might find embarrassing. We see patients for all concerns, head-to-toe, inside and out - and this includes the bowels! One common condition of the bowels, for which our GPs often provide advise, is Coeliac Disease - the topic of today's blog article.
What Is Coeliac Disease?
Coeliac disease is a condition that occurs when your body’s immune system mistakenly attacks gluten. This is different to an allergy, or an intolerance to gluten. Gluten - which is found in wheat, barley and rye - is a protein present in many foods including pasta, cakes, breakfast cereals, bread and beer.
Gluten is a protein found in many breakfast cereals
When someone with coeliac disease eats gluten, their immune system reacts by damaging the lining of the small intestine, which can lead to a number of symptoms such as:
- Diarrhoea, often with an unpleasant smell
- Bloating and flatulence (passing wind)
- Abdominal pain
- Loss of appetite
- Weight loss
- Feeling tired
- Ulcers around the mouth
- In children, not growing as much as would be expected
Coeliac disease can mimic symptoms of irritable bowel syndrome (IBS) and it is important make sure coeliac disease has been ruled out in these cases.
Who Does Coeliac Disease Affect?
Approximately 1 in every 100 people in the UK have coeliac disease. There is no clear pattern of inheritance, but the risk of developing coeliac disease is increased if a close relative also has it. Symptoms often develop either between 8-12 months old, or 40-60 years old and the disease is slightly more common in women than men.
Why Is My Body Fighting Itself?
Coeliac disease is an autoimmune disease, whereby the immune system mistakenly attacks part of the gluten while it is in the gut and this causes inflammation of the intestines.
Some research suggests that a combination of inherited and environmental factors (like infection with particular viruses) can cause the body to recognise gluten in this way.
The inflammation damages the intestines and stops them from working properly. This prevents the body from absorbing food efficiently and can cause pain or discomfort, while longer-term inflammation of the intestines can lead to the symptoms described above.
Diagnosing Coeliac Disease
Blood tests can be used to look for antibodies in the blood that react with gluten and cause the inflammation in the intestines. We often test for an antibody called Tissue Transglutaminase Antibody (tTG-IgA), which is present in approximately 98% of patients suffering with Coeliac disease.
Additionally, samples of intestine may be taken to check for inflammation. This involves passing a tube (called an endoscope) down your oesophagus and into your upper intestines, where a small sample will be taken for analysis with a microscope.
Find out more about the different types of coeliac disease test we offer by following the link. These tests don't work if you are already on a gluten-free diet, so its important to talk to your GP about possible tests.
Living With Coeliac Disease
Although there is currently no cure for coeliac disease, it is a condition that can be well managed with the correct advice.
Stopping eating gluten can control symptoms and help prevent complications, so adopting a gluten-free diet is the recommended way to control coeliac disease - in most people, this should prevent symptoms within a few weeks.
Even if symptoms are mild, it is recommended that people with coeliac disease adopt a gluten-free diet because continued consumption of gluten can lead to longer term complications. Adopting a gluten-free diet has become easier recently, as gluten is labelled as an ingredient on the packaging of most foods, and most restaurants can advise about any meals that contain gluten.
There are several complications associated with Coeliac disease, including;
- Weakening of the bones (osteoporosis), which can result from impaired absorption of calcium from the diet
- Anaemia (decreased number of red blood cells) can be caused due to a deficiency of iron, or vitamin B12/folate - the inflammation in your bowel can stop these vitamins and minerals being absorbed properly.
- Less common complications include an increased risk of some types of cancer, including bowel cancer
- If pregnant, there is a risk of having a baby with a low birth weight
These can usually be minimised by sticking to a gluten-free diet, and supplementing your diet with any necessary vitamins and minerals.
The inflammation of the bowel can stop key vitamins and minerals from being absorbed, such as iron and vitamin B12/ folate, which can lead to anaemia
If you would like to discuss your concerns regarding coeliac disease with a private doctor - whether you suspect you may have the condition, or you've been diagnosed and are struggling to manage your symptoms - do not hesitate to book a consultation at any of our nine GP surgeries located across London. Our experienced GP's are able to help with diagnosis, and answer any questions you may have regarding the condition.
By Ian Baines