Coeliac disease is an autoimmune condition of the small bowel caused by a reaction to gluten. Gluten is found in wheat, rye and barley. It is a common condition occurring in about 1 in every 100 people in UK. It is more common in Caucasian population.
Coeliac disease comes in different forms; typical, atypical, silent, latent and refractory. Typical coeliac disease has classical abdominal symptoms such as bloating, abdominal cramps, diarrhoea and constipation when ingesting gluten. Atypical coeliac disease is when a patient does not have gastrointestinal symptoms, instead they have extra intestinal symptoms such as migraine, ataxia and joint pains. Latent coeliac disease is when a patient tested negative for coeliac disease but later develop the disease. Refractory coeliac disease is when a patient continues to be clinical symptomatic despite being on a gluten free diet. Cross contamination of gluten free food with gluten containing food is often the cause of “refractory” coeliac disease.
Patients with coeliac disease may have other extra intestinal features such as dermatitis herpetiformis, dental enamel hypoplasia, iron deficiency anaemia, low vitamin D, short statue, delayed puberty, arthritis, osteopenia or osteoporosis, ataxia, psychiatric disorder.
Coeliac disease patients have raised anti-tissue tranglutaminase antibody and positive endomysial antibody. Patients often undergo gastroscopy to obtain a histological diagnosis of coeliac disese which show the presence of villous atrophy.
Coeliac disease is a lifelong condition. Patients need to be on gluten free diet indefinitely. The patient and family are encouraged to join the Coeliac UK Society for information and support.