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What is Coeliac Disease?

Coeliac disease is a condition characterised by inflammation of the lining of the small intestine due to an autoimmune reaction (body's immune system mistakenly attacks own healthy tissues) against gluten, a protein found in foods such as oats, wheat, rye, and barley. Intake of such foods may lead to gastrointestinal and malabsorptive problems.

Anatomy of the Human Digestive System

The small intestine of the human body consists of numerous small finger-like projections called villi, which line its inner wall. These villi provide a larger surface area for food to digest and absorb into the body. In patients with coeliac disease, these villi become inflamed and flatten due to the autoimmune reaction, thereby reducing the surface area for the absorption of nutrients.

Causes of Coeliac Disease

Coeliac disease occurs when your body's immune systems mistake gluten, a protein found in many foods, as a threat to the body and causes an inflammatory reaction in the small intestine. The cause of this autoimmune reaction is not very clear. A familial history and underlying conditions, such as type 1 diabetes and ulcerative colitis, increase your risk of developing coeliac disease.

Impact of Coeliac Disease

Coeliac disease usually causes an inflammatory reaction that leads to various gastrointestinal and malabsorptive problems. The condition may sometimes be associated with dermatitis herpetiformis, an itchy skin rash.

Symptoms of Coeliac Disease

The various symptoms of coeliac diseases include:

• Bloating and flatulence
• Weight loss
• Stomach pain
• Anaemia due to iron deficiency
• Numbness or tingling sensation in your hands and feet
• Fatigue and tiredness
• Swelling due to accumulation of fluid in the body
• Vomiting in children

Diagnosis of Coeliac Disease

Coeliac disease should be diagnosed at an early stage to avoid major health problems. Coeliac disease can be diagnosed with the help of:

• Blood tests: This test is used to measure the amount of antibodies released against gluten in your blood. Blood tests may also be ordered to detect anaemia, levels of iron, vitamins, protein, etc.
• Bowel biopsy: A small amount of bowel tissue is removed to examine the presence of any inflammation or flattening or damage.
• Gene testing: This test can be used to confirm the diagnosis if the blood tests or biopsy is unclear. Genes causing coeliac disease are identified with the help of a small blood sample or a buccal scrub.
• Bone density test: This test helps determine bone damage due to poor absorption of vitamin D and calcium by the intestine.

While undergoing these tests, you will be advised not to discontinue gluten intake to obtain appropriate results.

What if left Untreated?

If coeliac disease is left untreated for a long time, it may lead to several associated conditions such as poor nutrition due to mal-absorption of nutrients, and complications in other parts of the body such as skin, joints, liver, pancreas, thyroid gland, nervous system and reproductive tract. The severe reaction of your immune system to gluten intake may lead to a condition called dermatitis herpetiformis, which causes skin rashes on various parts of your body.

Treatment Options for Coeliac Disease

The foremost treatment for coeliac disease is avoiding foods containing gluten. Some of the common foods containing gluten include wheat, barley and rye used in bread, pasta, pastries, cereals, and cakes. You can substitute with gluten-free substitutes.

In addition to this, you may also be prescribed supplements for calcium, iron, and vitamin for a certain period to replenish lost vitamins and minerals while your digestive system is healing. Your doctor may prescribe medications to treat associated conditions such as dermatitis herpetiformis along with diet control.

Sometimes, the coeliac disease may hinder the functioning of your spleen, which may make you highly susceptible to infections. To avoid this, your doctor usually administers vaccinations against infectious diseases such as influenza, pneumonia and meningitis.

Outcomes of Treatment of Coeliac Disease

With a gluten-free diet, you can live a life free of symptoms of coeliac disease. Once diagnosed with coeliac disease, you will be closely monitored through regular follow-ups every three to six months initially, to ensure that you are progressing and maintaining a gluten-free diet, also to examine you for the development of osteoporosis (bone thinning).