Coeliac disease is a condition, sometimes called gluten-sensitive enteropathy, that results from hypersensitivity to gluten, a protein found in wheat, rye, and some other cereals. Exposure to foods containing gluten causes an abnormal immune response in which the lining of the small intestine is damaged. The condition leads to malabsorption and results in vitamin and mineral deficiencies.
Causes and Symptoms
Coeliac disease tends to run in families, and varies in severity. The disorder may first appear during infancy, or may not develop until adulthood. In babies, symptoms usually develop within six months of the introduction of gluten into the diet. The baby may become listless and irritable, develop vomiting and diarrhoea, and become dehydrated and seriously ill. Babies and children may also fail to grow or to gain weight, and may suffer from muscle wasting, especially around the buttocks.
In adults, symptoms that include tiredness, breathlessness, abdominal pain, diarrhoea, vomiting, and swelling of the legs may develop over several months. In addition, a chronic, distinctive rash called dermatitis herpetiformis may occur (this is rare).
Damage to the intestinal lining and malabsorption cause weight loss and result in faeces that are bulky and foul-smelling. The resulting vitamin and mineral deficiencies can result in anaemia as well as skin problems. Some affected people suffer damage to the intestinal lining but never develop symptoms of the disease.
Diagnosis and Treatment
Diagnosis may be made by blood tests but in most cases jejunal biopsies,in which tissue samples from the lining of the jejunum (the central part of the small intestine) are taken for examination, are also performed.
Coeliac disease is treated by a life-long gluten-free diet, which can relieve symptoms within weeks of its introduction. Specially manufactured foods, such as gluten-free flour and pasta, are available. Without such treatment, there may be a long-term risk of cancers developing in the small intestine.