Coeliac Disease

Coeliac disease is an autoimmune condition in which eating gluten — a protein found in wheat, barley, and rye — triggers an immune reaction that damages the lining of the small intestine, impairing nutrient absorption.

• Diarrhoea, bloating, and abdominal pain after eating gluten-containing foods
• Unintentional weight loss
• Fatigue, often related to iron or other nutrient deficiencies
• In children: poor growth or delayed puberty
• Some people have subtle or no digestive symptoms and are diagnosed due to unexplained anaemia or other nutrient deficiencies

• Results from an abnormal immune response to gluten in genetically susceptible individuals.
• Family history of coeliac disease increases risk.
• Often associated with other autoimmune conditions, such as type 1 diabetes or autoimmune thyroid disease.

• Diagnosed with blood tests for specific antibodies associated with coeliac disease, done while the person is still eating gluten.
• A small bowel biopsy, obtained via upper endoscopy, is generally used to confirm the diagnosis by showing characteristic damage to the intestinal lining.
• It is important not to start a gluten-free diet before testing, as this can make the results inaccurate.

A strict, lifelong gluten-free diet is the only effective treatment, requiring avoidance of wheat, barley, and rye in all forms.

Most people notice significant improvement in symptoms within weeks of starting a gluten-free diet, with gradual healing of the intestinal lining over months.

Nutrient deficiencies, such as iron or other vitamin deficiencies resulting from poor absorption, are corrected with appropriate supplementation.

Ongoing follow-up helps confirm the response to diet, ensure nutrient levels normalise, and monitor for associated conditions.

Dietary guidance from someone experienced in gluten-free eating is valuable, as gluten can be present in less obvious food sources.

• Follow a strict gluten-free diet consistently once diagnosed, as even small amounts of gluten can cause ongoing intestinal damage.
• Read food labels carefully, as gluten can appear in less obvious processed foods.
• Attend regular follow-up to monitor nutrient levels and response to treatment.
• Family members of someone with coeliac disease may wish to discuss testing with a health worker, given the genetic component.