Gluten-free diets are very common today. While for some people this is a lifestyle choice, for people with coeliac disease it isn’t optional.
Coeliac disease is an autoimmune disorder that’s triggered when the individual eats gluten. It affects around 1% of the UK population, but only 24% of those are diagnosed. Grains like wheat, barley and rye all contain the protein gluten. It’s what gives bread its chewy texture and makes the dough elastic.
When someone who has coeliac disease eats food that contains gluten, the body responds to the protein by damaging its own villi (these are small, finger-like projections that are found along the walls of the small intestine).
Unless you’ve started exhibiting symptoms of coeliac disease or have an increased risk of developing them, routine testing for coeliac disease is not recommended.
The most common symptom of coeliac disease is diarrhoea. This is caused by malabsorption, or the body’s inability to fully absorb nutrients.
Steatorrhoea can develop as a result of this, which is a condition where a person’s stools (poo) contain an abnormally high level of fat. The stools can become frothy, greasy or have a strong odour because of these fat levels. Toilets may struggle to flush these stools.
The following gut-related symptoms are also common:
- sore tummy
- throwing up (especially common in kids)
- bloating and flatulence (passing wind)
More general symptoms can also be an issue, such as…
- vitamin B12 folate deficiency anaemia or iron deficiency anaemia, resulting in extreme tiredness (fatigue)
- skin irritation
- peripheral neuropathy (numbness or tingling in your hands and feet)
- oedema (fluid build-up resulting in swollen hands, feet, arms and legs)
- disorders that affect co-ordination, balance and speech (ataxia)
- difficulty getting pregnant
- unexpected weight loss
- your stools are larger than usual and can be difficult to push out
Keep in mind that breastfeeding babies will often go a week without doing a poo – this does not mean they’re constipated.
Feeling sick, bloated or having a sore stomach may also be symptoms. In babies and toddlers, you should look out for symptoms like:
- having low energy and not feeling like playing
- soiling themselves (in potty-trained toddlers)
- being irritable, angry or unhappy
Vitamin B12 or Folate Deficiency Anaemia
If your red blood cells contain an abnormally low amount of a substance called haemoglobin, or you have fewer red blood cells than normal, this is called anaemia. A wide range of symptoms are associated with vitamin B12 or folate deficiency anaemia. If the condition goes untreated these symptoms can become severe, but in most cases they will develop gradually.
The following are the most common symptoms associated with anaemia in general:
- fatigue (feeling really tired)
- feeling short of breath
- sore head
- palpitations (pounding or irregular heartbeat)
- weight loss and not feeling hungry
- tinnitus (hearing sounds coming from inside the body, rather than from an outside source)
- pale skin
- feeling faint
- lack of energy (lethargy)
Not all of these symptoms are required for you to be diagnosed with coeliac disease. In fact, sometimes diagnose is made all the more difficult by the fact that some people show no symptoms at all.
The majority of people who have coeliac disease will never find out about their condition. As we’ve already mentioned, it’s believed that as few as 24% of those with the disease actually get diagnosed. Even in the cases where a diagnosis happens, it can take years as the damage to the intestine is very slow and symptoms are so varied.
If you think you have coeliac disease, your doctor can check using two blood tests:
- genetic testing to look for human leukocyte antigens to rule out coeliac disease
- certain antibodies are detected using a serology test
To make sure the results are accurate, if you’re already on a gluten-free diet, you’ll need to come off it before taking the antibody test.
You’ll probably need to have an endoscopy done if the blood test suggests you could have coeliac disease. This checks for damage to the small intestine by removing a tiny bit of tissue for your doctor to test.
Coeliac disease doesn’t currently have any form of drug-based “cure”. A strict gluten-free diet will be necessary to moderate your symptoms. A vast range of products contain gluten including bread, cake and other baked goods, as well as beer, pasta, cereals, and even some toothpastes and medications.
If you develop a skin rash your doctor should prescribe an appropriate medication, and if you have a severe nutritional deficiency they may ask you to take gluten-free vitamins and mineral supplements.
For more information about coeliac disease, check out Need2Know’s Essential Guide to Coeliac Disease which explains what the disease is, how it’s diagnosed, how it will affect your diet and social life, and, most importantly, how you can live happily and healthily with the condition.