Coeliac disease

Coeliac disease is a common digestive condition where the small intestine becomes inflamed and unable to absorb nutrients.

It can cause a range of symptoms including diarrhoea, abdominal pain and bloating.

Coeliac disease is caused by an adverse reaction to gluten, a dietary 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.

Symptoms of coeliac disease

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

• diarrhoea, which may smell particularly unpleasant
• abdominal pain
• bloating and flatulence (passing wind)
• indigestion 
• constipation

Coeliac disease can also cause a number of more general symptoms, including:

• fatigue as a result of malnutrition (not getting enough nutrients from food) 
• unexpected weight loss 
• an itchy rash (dermatitis herpetiformis)
• problems getting pregnant 
• nerve damage (peripheral neuropathy)
• disorders that affect co-ordination, balance and speech (ataxia)

Children with coeliac disease may not grow at the expected rate and may have delayed puberty. 

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.

In 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.

It's not entirely clear what causes the immune system to act in this way, but a combination of genetics and the environment appear to play a part.

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

Read more about the causes of coeliac disease.

Treating coeliac disease

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

Even if you have non-existent or mild symptoms, changing your diet is still recommended because continuing to eat gluten can lead to serious complications.

It's important to ensure that 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 treating coeliac disease.

Complications of coeliac disease

Complications of coeliac disease only tend to affect people who continue to eat gluten, or those who've 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's affected

Coeliac disease is a common condition that affects approximately one 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. It can develop at any age, although symptoms are most likely to develop:

• during early childhood – between eight and 12 months old, although it may take several years before a correct diagnosis is made 
• in later adulthood – between 40 and 60 years of age

People with certain conditions, including type 1 diabetes, autoimmune thyroid disease, Down's syndrome and Turner syndrome, have an increased risk of getting coeliac disease.

First-degree relatives (parents, brothers, sisters and children) of people with coeliac disease are also at increased risk of developing the condition.

Diagnosing coeliac disease

Routine testing for coeliac disease isn't carried out in England.

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

First-degree relatives of people with coeliac disease should be tested.

See diagnosing coeliac disease for more information about when testing for coeliac disease should be carried out. 

Help and support

Coeliac UK is a UK-based charity for people with coeliac disease.

Its website contains a range of useful resources, including information about the gluten-free diet, as well as the details of local groups, volunteering and ongoing campaigns.

The charity also has a telephone helpline, 0333 332 2033, open Monday to Friday from 9am to 5pm.