AN estimated one in every 100 persons in the UK have coeliac disease. However with symptoms similar to those of irritable bowel syndrome (IBS), and a group who do not have any complaints at all, it is thought that half a million individuals remain undiagnosed, putting them at risk of complications.

Coeliac disease is an autoimmune disease, whereby the body reacts to gluten as a threat and forms antibodies to fight it. Unfortunately this causes inflammation to the lining of the small bowel, damaging it and preventing it from absorbing vital nutrients. Gluten is a protein found in the cereals barley, rye, wheat and some oats. Common foods containing gluten are pasta, bread, breakfast cereals, cakes and beer.

As mentioned above, some persons with coeliac disease may have no symptoms whatsoever. However common complaints include abdominal pain and bloating, constipation or diarrhoea. Symptoms can affect the rest of the body for example recurrent mouth ulcers and a rash known as dermatitis herpetiformis. Sufferers sometimes report simply feeling constantly unwell. The first step in diagnosis is a blood test which can be organised by your routine GP. You should not exclude gluten from your diet before this is performed as it may give a negative reading. Coeliac disease is more common in some groups, for example those with other autoimmune diseases such as type 1 diabetes, as well as some genetic conditions including Down’s syndrome. First degree relatives of persons with coeliac disease are also at an increased risk. In addition, coeliac disease may be diagnosed while investigating other conditions such as iron deficiency, struggling to conceive or osteoporosis (thinning of the bones).

After a positive blood test, you will usually be referred to a gastroenterologist for a gastroscopy (camera test of the stomach and small intestine). A biopsy (tissue sample) will be taken, which can then be looked at under the microscope to examine for changes normally found in those with coeliac disease.

Current treatment is lifelong total exclusion of gluten, as even small amounts may increase the chance of symptoms recurring as well as the risk of complications. Abdominal symptoms often improve within a few weeks of excluding gluten, however for some it may take up to a year. You may initially need to take vitamin supplements to correct any deficiencies. Coeliac disease also affects the functioning of your spleen, so if diagnosed, you will be offered certain immunisations.

A diagnosis can seem very daunting, however support is available. Your local dietician will be able to help and the charity Coeliac UK provides education and support. Gluten free foods are now marked as such and many restaurants are able to cater for this as well.

There are many myths surrounding coeliac disease. Many of us will notice benefits from reducing the amount of gluten in our diet, including less bloating and perhaps weight loss. However this is not the same as coeliac disease and I would advise against self-diagnosis, and seek guidance and support from your normal doctor. Half a million individuals remain undiagnosed, putting them at risk of complications.

Abdominal symptoms often improve within a few weeks of excluding gluten”

Visit www.coeliac.org.uk