FAQ’s
faq’s about coeliac disease
1. What is coeliac disease (CD)?
2. What is gluten?
3. What are micro-villi?
4. How common is coeliac disease?
5. What are the signs and symptoms?
6. How is coeliac disease diagnosed?
7. What are some associated conditions to coeliac disease?
8. What is the treatment for coeliac disease?
9. Where can I go for local support?
What is coeliac disease (CD)?
Coeliac disease or celiac disease is an autoimmune disorder of the small bowel caused by a permanent intestinal intolerance (allergy) to gluten. Left untreated, it destroys the micro-villi (small finger-like projections) in the small bowel.
What is gluten?
Gluten is a protein found in the grains of wheat, barley, oats, rye and triticale (a hybrid grain of wheat and rye).
What are micro-villi?
Micro-villi are small, finger-like hairs that function to increase the surface area of the small bowel. Damage of the micro-villi results in malnutrition, dysfunction of enzyme production and inflammation. This results in poor nutrient absorption and many deficiencies ensue.
How common is coeliac disease?
Coeliac disease is common in Australia. Although firm statistics are difficult to obtain it is considered that 1 in 100 people have the disease. However, currently only 10 – 20% are currently diagnosed.
What are the signs and symptoms?
Signs and symptoms are numerous and vary from person to person. Few people suffer from “classic” intestinal symptoms. Some people may have a few symptoms whilst others may have many. It is also possible to have no symptoms but still have damage to the intestinal lining from gluten intolerance.
Dermatitis herpetiformis (DH) is a skin condition that presents as a rash of little blisters on certain areas of the body, usually on the knees, elbows and buttocks. It can also present on the back, sacrum, face, trunk, and inside the mouth. Sensitivity to gluten can bring on the rash and the digestive system may also be affected, resulting in a form of coeliac disease. Although rare, DH can continue to present itself even after years on a gluten free diet.
Signs & symptoms:
• Fatigue, lethargy and weakness
• Headaches
• Flatulence and abdominal distension, bloating
• Altered mental alertness
• Anaemia – iron or folic acid deficiency, sometimes only appearing in pregnancy
• Intestinal upsets, pain, colicky
• Cramping and bloating
• Constipation
• Diarrhoea
• Pale, bulky, foul-smelling stools
• Nausea and vomiting
• Weight loss (although this is not always a symptom)
• Irritability
• Easy bruising of the skin
• Cancer (gastrointestinal carcinoma or lymphoma)
• Dental defects
• Mouth ulcers
• Oral swelling
• Skin rashes (Dermatitis herpetiformis)
• Osteoporosis, bone pains and fractures
• Low blood calcium and magnesium levels with muscle cramps and spasms
• Vitamin and mineral deficiencies, Vitamin B12, A, D, E and K, folic acid, calcium and iron
• Delayed puberty
• Miscarriages or infertility
• Reduction in sperm counts in men
• Early menopause
• Muscle aches – myopathy
How is coeliac disease diagnosed?
Screening for coeliac disease is by a blood test to detect the presence of antibodies produced by the coeliac in response to gluten in the diet. Diagnosis is determined by a small bowel biopsy (called an endoscopy), which is necessary to check whether the lining of the villi of the small intestine has been damaged. It is imperative that you do not begin a gluten free diet before being tested, as your results will come back negative. Coeliac disease requires a lifelong abstinence from gluten to prevent the development of malignancy and other associated conditions. To be screened positively for coeliac disease you must have an endoscopy and biopsy. Once diagnosis is confirmed you will most likely be tested for nutritional deficiencies.
What are some associated conditions to coeliac disease?
• Dermatitis herpetiformis
• IgA deficiency
• Diabetes mellitus (insulin dependent type 1)
• Osteoporosis, osteopenia
• Anaemia
• Chronic fatigue syndrome
• Epilepsy
• Thyroid disorders
• Kidney disease
• Nerve disease
• Mental illness
• Infertility
• Miscarriages
• Lactose intolerance and other allergies
• Arthritis
• Fibromyalgia
• Asthma
What is the treatment for coeliac disease?
Treatment requires medical diagnosis followed by a strict gluten free diet for life. Even small amounts of gluten can prevent the gut from healing. Consultation with an accredited dietician is advisable as often there is an associated vitamin and mineral deficiency which requires addressing. It is usually a daunting task to determine what is “allowable” in your new diet. There is an abundance of “safe” gluten free foods and alternatives that a dietician will help you with.
Gluten is a hidden ingredient in many processed foods and medications, as well as in obvious sources such as breads, pasta and cereals. ALWAYS read food labels to check for sources of gluten.
Please note: It is not sensible or helpful to begin a gluten free diet prior to a biopsy, as this can lead to an inconclusive diagnosis. “Rule it out or rule it in” before you strictly adhere to a gluten free diet.
Where can I go for local support?
The Coeliac Society provides educational material, support and access to dieticians who can provide you with practical advice. It also provides a quarterly magazine and updates for events and social evenings, and a list of restaurants in your local area that have gluten free items on their menus.
