Coeliac disease (coeliac gluten sensitivity) is a small intestine disease caused by gluten, a protein found in wheat, rye and barley. Due to genetic susceptibility, the surface of small intestine does not tolerate gluten. Coeliac disease is an autoimmune disease, which means that immune system mistakes some part of the body as a pathogen and attacks its own cells. In coeliac disease an immunological inflammation damages the villi in the small bowel and thus the nutrients will not be utilized normally. The condition may lead to various symptoms or signs of malabsorption. Coeliac disease prevalence is 1–2% of global population. Recent research has showed that coeliac disease exists also within Chinese population but is currently under-diagnosed.
The most common symptoms of coeliac disease are diarrhea and weight loss. However, the symptoms may be only mild digestion symptoms, such as pains, loose stools or flatulence. Coeliac disease can also be asymptomatic. The nutritional and vitamin deficiencies may cause tiredness and weak overall constitution or anemia or even osteoporosis. Coeliac disease can also manifest itself as so called dermatitis herpetiformis, which is an itchy skin rash, commonly existing on knees, elbows, scalp and buttocks.
Coeliac disease can be screened with antibody tests in the blood. Diagnosis is recommended to be confirmed by a small bowel biopsy to find the villous atrophy typical for the condition. Gluten-free diet should never be started before the antibody screening or biopsy. This is because when following the gluten-free diet the villi may get recovered and specific antibodies disappear. If the typical CD findings can no longer be recognised, the correct diagnosis will be very difficult to confirm.
Online educational resources
- Coeliac diseases and gluten: facts, fiction and controversies
- Understanding coeliac disease and gluten sensitivity: your gut reaction
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