What is coeliac disease?
Coeliac disease is an autoimmune disease affecting the small intestine. For individuals who have coeliac, consumption of foods containing more than 20 parts per million (20ppm) or 50mg of gluten – the protein found in wheat, barley, rye, spelt, and kamut, and in oats by contamination – can result in damage to the villi on the brush border of the small intestine. 20ppm or 50mg of gluten is the equivalent of a pixel on your screen! The resulting damage can lead to a range of symptoms and nutrient deficiencies and may also result in a secondary lactose intolerance.
Why is coeliac disease not a food intolerance?
It’s important to understand that while coeliac disease may commonly be referred to as a gluten intolerance, it’s not an IgG-mediated food intolerance, meaning that an IgG food intolerance test may be negative for wheat or gluten.
What are the symptoms of coeliac disease?
The symptoms of coeliac disease are not only digestive – they can be systemic and generalised too:
- Digestive: diarrhoea, stomach pain/discomfort, bloating, flatulence, indigestion, constipation, nausea, vomiting, lactose intolerance
- Skin: dermatitis herpetiformis (blistering itchy rash)
- Neurological: Peripheral neuropathy, ataxia (affecting balance, coordination, speech), brain fog
- Mental health: depression, anxiety
- Other: Unintentional weight loss, failure to thrive (in children), fatigue (from malnutrition), infertility
What could happen if I’m coeliac but continue eating gluten?
Complications of long-term undiagnosed or unmanaged coeliac disease include osteoporosis, iron deficiency anaemia, b12 deficiency anaemia, folate deficiency anaemia, and an increased risk of bowel cancer.
How can I test for coeliac disease?
While your doctor can potentially refer you for coeliac testing, obtaining a diagnosis may take several years without proactive involvement. This delay often occurs because the symptoms of coeliac disease can be mistakenly attributed to other conditions such as IBS, depression, eczema, poor diet, and more.
The good news is that we now have a finger prick coeliac test – no more lengthy delays waiting to be referred for a blood test, and no more waiting for results. Now you can simply test at a time that suits you, from the comfort of your own home, and with results available in as little as 10 minutes. Once you have your result, you can speak to your GP to confirm the diagnosis and access extra support for your symptoms.
If you receive a positive coeliac test result your doctor will refer you for a biopsy of the small intestine during a gastroscopy to confirm the diagnosis. This biopsy would show the flattened/damaged villi caused by gluten.
Do I need to eat gluten in order to test for coeliac disease?
In order to obtain an accurate result, it’s important to be following a gluten challenge diet for at least 6 weeks prior to testing – if you’ve not changed your diet already then you may not need to make any changes. If you have already changed your diet, then you may need to reintroduce gluten.
The gluten challenge diet is as follows:
- Consume gluten, equivalent to 2 slices of bread, in at least one meal per day for the 6 weeks prior to testing
- Do not start a gluten free diet regardless of symptoms
If consuming gluten makes you feel particularly unwell, you should speak to your GP about your symptoms.
What is the treatment for coeliac disease?
The treatment for coeliac disease is, in theory, very simple: life-long total gluten avoidance. However, in reality, this can be difficult since 20ppm is a very small amount of gluten and foods are easily contaminated by cross-contact e.g. in busy restaurants, home toasters, while preparing food for others, and so on.
What should I do if I suspect I might have coeliac disease?
The first step would be to make sure you are consuming gluten, and then take a test – with coeliac disease, it is important not to guess.
The Rapid Coeliac Self-Test allows you to gain clarity in just a few minutes, helping you to get further help and advice from your GP for your symptoms.
