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What is Coeliac Disease?

Coeliac Disease or Celiac Disease is an auto immune disease. The auto immune reaction is triggered by gluten, gluten is a protein found in wheat, barley, rye and oats (some ceoliacs (celiacs) may be able to tolerate oats that have not been cross contaminated in the production of foods). Eating foods that contain gluten causes the body to attack itself resulting in damage to the intestines and interferes with the absorption of nutrients into the body. Some professionals suggest children should not eat oats at all.

The Effects of Coeliac Disease

When people eat products containing gluten their immune system responds by damaging the villi in their intestines. Villi are tiny protrusions within the intestines which are responsible for absorbing nutrients through the intestinal wall into the blood stream. This leads to the person becoming malnourished.

The intestines are damaged by the body's immune system in CoeliacsHealthy villi absorb nutrients from food into the bodyDamaged villi become flattened and cannot absorb food

Celiac Disease is also known as celiac sprue, nontropical sprue, and gluten-sensitive enteropathy.

Is Coeliac Disease hereditary?

Evidence suggests that Celiac Disease is hereditary and runs in families, but it can also be triggered by surgery, viral infection, stress, pregnancy or child birth.

Symptoms

Symptoms can be acute or few and far between. Symptoms vary from one person to another, with some having cronic symptoms and others having none.

Children often display digestive problems or growth problems. Symptoms may cause failure to thrive, delayed growth, shortness in stature. In children the malnutrition may lead to problems later in life such as irritable bowel syndrome, bowel cancer or osteoporosis, but early detection and correction of the diet can reduce these risks. Some symptoms may include:

abdominal bloating and paindiarrheavomitingconstipationpale, foul-smelling, or fatty stoolweight loss

Adults may live without symptoms but it is important to be diagnosed to ensure enough nutrients are absorbed. Adults who have had celiac disease for many years may have an increased risk of osteoporosis, anemia, intestinal cancer, liver disease and even liver disease.

unexplained iron-deficiency anemiafatigue / excessive tirednessbone or joint painarthritisbone loss or osteoporosisdepression / anxietytingling numbness in the hands and feetseizuresulcers inside the mouthan itchy skin rash called dermatitis herpetiformis (usually with small blisters)missed menstrual periodsinfertility or recurrent miscarriage

How is Coeliac Disease Diagnosed?

Coeliac Disease is not easily diagnosed as many symptoms are similar to other conditions. Doctors are becoming more aware of the varied symptoms Coeliac Disease presents and blood tests have become very accurate in diagnosing the condition.

A blood test will be taken to identify high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA). It is important to eat your normal diet before any blood tests as the antibodies are only produced when the gluten is eaten.

If the blood tests indicate there is a possibility of Coeliac Disease, then it will be suggested that an intestinal biopsy is taken to assess the damage to the intestines. During the biopsy a small sample of the intestinal lining will be taken. Again, it is important to continue with your normal diet prior to the biopsy as the intestines will start to repair once the antibodies are not being produced by the body. It is important to get a correct diagnosis.

Dermatitis Herpetiformis is a small itchy rash with small blisters. Often people with Dermatitis Herpetiformis do not experience digestive symptoms of and Coeliac Disease. The rash can be treated but it is important that a gluten free diet is still followed.

Screening

In the UK and US, Coeliac Screening is not taken routinely but if there is a family history or direct connection with someone who has Coeliac Disease, it is worth having the blood test. It is thought that there is a one in ten chance of having Coeliac Disease if there is a direct family member with the condition.

Treatment

There is only one treatment for Coeliac Disease and it is the complete abstinence of foods, medicines and cosmetics containing gluten. This will be mean checking every product, used or digested.

Why are celiac disease symptoms so varied?

There is extensive research going on into why some people develop coeliac diseae. People and children display a range of symptoms but don't necessarily experience all of them.

Research is studying how long a person was breastfed, they feel there are three key factors - How long a person was breastfed, the age a person was weaned, the quantity of gluten contained food is consumed.

Some studies have shown, that the longer a person was breastfed, the later the symptoms of celiac disease actually appear.

Older people may have had the disease for decades and this may influence the damage of the intestine. It is thought the longer a person has undiagnosed Coeliac disease the more risk of other complications arising!

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