Coeliac Disease

Coeliac disease is a chronic autoimmune disorder that primarily affects the small intestine and is caused by a reaction to gluten, a protein found in wheat, barley, and rye. It is also known as celiac sprue or gluten-sensitive enteropathy.

What is Coeliac Disease?

Coeliac disease occurs when the immune system mistakenly attacks the lining of the small intestine, causing inflammation and damage to the villi, which are the finger-like projections that absorb nutrients from food. This leads to malabsorption of essential nutrients, including vitamins, minerals, and proteins.

Symptoms of Coeliac Disease

The symptoms of coeliac disease can vary widely and may include:

• Diarrhea or abdominal pain
• Fatigue or weakness
• Weight loss or difficulty gaining weight
• Nausea and vomiting
• Bloating or gas
• Abdominal cramps
• Itchy skin rash (dermatitis herpetiformis)
• Mouth ulcers
• Joint pain or arthritis
• Anemia or iron deficiency
• Osteoporosis or osteopenia (thin or brittle bones)
• Numbness or tingling in the hands and feet
• Seizures or neurological problems (rarely)

Causes and Risk Factors of Coeliac Disease

The exact cause of coeliac disease is not fully understood, but it is believed to involve a combination of genetic and environmental factors. The following are known risk factors:

• Family history: Having a first-degree relative (parent or sibling) with coeliac disease increases the risk
• Genetic predisposition: Certain genetic markers, such as HLA-DQ2 and HLA-DQ8, increase the risk
• Autoimmune disorders: Conditions like type 1 diabetes, rheumatoid arthritis, and thyroid disease may increase the risk
• Infections: Certain infections, such as rotavirus, may trigger the onset of coeliac disease in some individuals

Diagnosis of Coeliac Disease

Diagnosing coeliac disease typically involves a combination of:

• Blood tests: To detect the presence of certain antibodies (e.g., tissue transglutaminase antibody, endomysial antibody)
• Intestinal biopsy: To examine the lining of the small intestine for damage and inflammation
• Genetic testing: To identify genetic markers associated with coeliac disease

Treatments for Coeliac Disease

The primary treatment for coeliac disease is a strict gluten-free diet, which involves:

• Avoiding all foods containing wheat, barley, and rye
• Reading food labels carefully to identify hidden sources of gluten
• Choosing gluten-free alternatives, such as rice, quinoa, and corn
• Working with a registered dietitian or healthcare provider to develop a personalized meal plan

In addition to dietary changes, some individuals may require:

• Vitamin and mineral supplements: To address malabsorption and deficiencies
• Corticosteroids: To reduce inflammation in severe cases
• Immunosuppressants: To manage complications, such as refractory coeliac disease

Complications of Coeliac Disease

If left untreated or poorly managed, coeliac disease can lead to:

• Malnutrition and related health problems (e.g., anemia, osteoporosis)
• Increased risk of other autoimmune disorders (e.g., type 1 diabetes, rheumatoid arthritis)
• Refractory coeliac disease: A condition where the intestine does not respond to a gluten-free diet
• Enteropathy-associated T-cell lymphoma: A rare but potentially life-threatening complication

Living with Coeliac Disease

With proper diagnosis, treatment, and management, individuals with coeliac disease can lead active and healthy lives. It is essential to:

• Work closely with a healthcare provider to monitor progress and adjust the treatment plan as needed
• Stay informed about gluten-free foods, products, and resources
• Connect with support groups and online communities to share experiences and advice