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Autoimmune

Coeliac Disease

Also known as: Coeliac Disease (Celiac Sprue)

Coeliac disease is a serious autoimmune condition where ingestion of gluten triggers an immune response that damages the small intestine lining, impairing nutrient absorption.

Understanding Coeliac Disease

Coeliac disease affects approximately 1% of the global population, though up to 80% of cases remain undiagnosed. It is not a food intolerance — it is a serious autoimmune condition.

Gluten (found in wheat, barley, and rye) triggers an immune response that damages the villi lining the small intestine. This villous atrophy impairs nutrient absorption, leading to deficiencies in iron, calcium, B12, and folate.

Coeliac disease has diverse presentations — many patients have 'silent' or 'atypical' disease with minimal digestive symptoms but significant extra-intestinal manifestations.

Common Symptoms

People with Coeliac Disease often experience the following symptoms.

Digestive Symptoms

Diarrhoea, bloating, abdominal pain, and gas — the classic presentation, though not present in all patients.

Iron-Deficiency Anemia

May be the only presenting sign. Impaired iron absorption in the duodenum causes chronic anemia.

Dermatitis Herpetiformis

An intensely itchy, blistering skin rash, most commonly on elbows, knees, and buttocks — pathognomonic for coeliac disease.

Bone Disease

Impaired calcium and vitamin D absorption leads to osteoporosis and increased fracture risk.

Risk Factors

Certain factors may increase your likelihood of developing Coeliac Disease.

Family history (10% risk in first-degree relatives)

Type 1 diabetes

Other autoimmune conditions

Down syndrome or Turner syndrome

Treatment Options

Common approaches to managing coeliac disease. Always consult a healthcare provider for personalized treatment.

Strict Gluten-Free Diet

The only treatment. Complete elimination of wheat, barley, and rye. Even small amounts of gluten cause damage.

Nutritional Supplementation

Iron, calcium, vitamin D, B12, and folate supplementation to correct deficiencies during intestinal healing.

Follow-Up Monitoring

Serial blood tests (tTG-IgA) and potential repeat biopsy to confirm healing on gluten-free diet.

Refractory Disease Management

For the rare cases that do not respond to strict gluten-free diet, immunosuppressive therapy may be needed.

How It's Diagnosed

Blood tests for tissue transglutaminase IgA (tTG-IgA) antibodies. Confirmed by duodenal biopsy showing villous atrophy. Patients MUST be eating gluten during testing for accurate results.

When to See a Doctor

See a doctor if you have persistent digestive symptoms, unexplained anemia, bone pain, or a blistering skin rash (dermatitis herpetiformis), especially with a family history of coeliac disease.

Prevention Strategies

Steps that may help reduce the risk of developing or worsening coeliac disease.

No prevention for coeliac disease itself

Strict gluten-free diet prevents complications

Screen first-degree relatives

Regular monitoring of nutritional status

Potential Complications

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

  • Osteoporosis and fractures
  • Other autoimmune diseases
  • Small bowel lymphoma (rare, in untreated disease)
  • Infertility and pregnancy complications

Frequently Asked Questions

Is coeliac disease the same as gluten intolerance?

No. Coeliac disease is an autoimmune condition with measurable antibodies and intestinal damage. Gluten sensitivity does not cause this damage.

Can you grow out of coeliac disease?

No. It is a lifelong condition. The gluten-free diet must be maintained permanently.

How strict does the gluten-free diet need to be?

Very strict. Even 50mg of gluten (a small breadcrumb) can trigger immune-mediated intestinal damage.

Think you might have Coeliac Disease?

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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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