Coeliac disease

Coeliac disease is a common digestive condition where a person has an adverse reaction to gluten.

Eating foods containing gluten can trigger a range of symptoms, such as:

diarrhoea, which may smell particularly unpleasant
bloating and flatulence (passing wind)
abdominal pain
weight loss
feeling tired all the time as a result of malnutrition (not getting enough nutrients from food)
children not growing at the expected rate

Symptoms can range from mild to severe.

Read more about the symptoms of coeliac disease.

What causes coeliac disease?

Coeliac disease is an autoimmune condition. This is where the immune system – the body's defence against infection – mistakenly attacks healthy tissue.

Coeliac disease isn't an allergy or an intolerance to gluten.

In cases of coeliac disease, the immune system mistakes substances found inside gluten as a threat to the body and attacks them.

This damages the surface of the small bowel (intestines), disrupting the body's ability to absorb nutrients from food.

Exactly what causes the immune system to act in this way is still not entirely clear, although a combination of a person's genetic make-up and the environment appear to play a part.

Read more about the causes of coeliac disease.

Gluten

Gluten is a protein found in three types of cereal:

wheat
barley
rye

Gluten is found in any food that contains the above cereals, including:

pasta
cakes
breakfast cereals
most types of bread
certain types of sauces
some types of ready meals

In addition, most beers are made from barley.

Treating coeliac disease

There is no cure for coeliac disease, but switching to a gluten-free diet should help control symptoms and prevent the long-term consequences of the disease.

Even if symptoms are mild or non-existent, it is still recommended to change your diet, as continuing to eat gluten can lead to serious complications.

It is important to make sure your gluten-free diet is healthy and balanced. An increase in the range of available gluten-free foods in recent years has made it possible to eat both a healthy and varied gluten-free diet.

Read more about the treatment of coeliac disease.

Screening

Currently, screening for coeliac disease is not routinely carried out in England.

It is usually only recommended for people at an increased risk of developing the condition, such as those with a family history of the disease.

It is recommended that first-degree relatives (parents, brothers, sisters and children) of people with coeliac disease are screened.

See diagnosing coeliac disease for more information about who should be screened for coeliac disease.

Complications

Complications of coeliac disease only tend to affect people who continue to eat gluten or who have yet to be diagnosed with the condition, which can be a common problem in milder cases.

Potential long-term complications include:

osteoporosis (weakening of the bones)
iron deficiency anaemia
vitamin B12 and folate deficiency anaemia

Less common and more serious complications include those affecting pregnancy, such as having a low-birth weight baby, and some types of cancers, such as bowel cancer.

Read more about the complications of coeliac disease.

Who is affected?

Coeliac disease is a common condition that affects approximately 1 in every 100 people in the UK.

However, some experts think this may be an underestimate because milder cases may go undiagnosed or be misdiagnosed as other digestive conditions, such as irritable bowel syndrome (IBS).

Reported cases of coeliac disease are two to three times higher in women than men and can develop at any age, although symptoms are most likely to develop:

during early childhood – at between 8 and 12 months old (though it may take several years before a correct diagnosis is made)
in later adulthood – between the ages of 40 and 60 years