Here’s a fact you probably didn’t know about Coeliac disease: according to the NHS, it affects around 1 per cent of people in the UK. While this may not sound like much, when you consider that the estimated population of our country is around 60 million, that’s still around 600,000 sufferers.
However, many doctors think that there may be thousands more living with the condition but who are unaware that they have it. Furthermore, due to the often nonspecific nature of symptoms, the condition also has quite a high rate of misdiagnosis, and can be quite easily mistaken for a number of different illnesses.
Regular Erisea readers will know that this week marks Coeliac Awareness Week, a valuable campaign which aims to raise understanding of the condition. This includes alerting those who may be experiencing coeliac symptoms but have not yet been diagnosed, to the importance of recognising and treating the condition.
At Erisea we like to do our bit, so we got together with Dr Wayne of Treated.com and asked him:
Dr Wayne, why is getting a diagnosis for coeliac disease so important?
Hi Erika, thanks for your question and for having me at Erisea.
What many people don’t realise about coeliac disease is that, as well as causing some very uncomfortable symptoms, it can also lead to serious long-term health issues in those cases where it is not diagnosed.
First of all, let’s talk about how the condition works in the body, then we’ll move onto symptoms and discuss the potential risks of the condition when left unmanaged.
As you’ve covered here on Erisea, coeliac disease is what’s known as an autoimmune condition. This is where the immune system misinterprets a harmless substance in the body as a threat. It’s not quite the same as an allergy, as the chemical intricacies are slightly different, but it’s very similar. The immune system will then kick into action to try to eradicate what it thinks is an infection, by releasing certain chemicals which cause inflammation.
In the case of coeliac disease, the irritant or ‘antigen’ is a type of protein called gliadin, which is derived from gluten (found most prominently in foods such as bread and pasta). When ingested, this triggers the release of antibodies in the gut, causing the wall of the intestine to swell and become inflamed, resulting in pain and discomfort.
On the lining of the gut are millions of tiny tubes, called intestinal villi. When your body digests food, these tubes widen, allowing your intestine to absorb the nutrients you need. But when the gut swells and becomes inflamed in coeliac disease, these villi become restricted and cannot work properly. This leads to ‘malabsorption’ and, as explained over at Treated.com, can result in persistent diarrhoea.
The severity of coeliac disease can vary. So someone who only has a mild case may just notice a bit of pain and looser stools to start with. This is why the condition so often gets confused with irritable bowel syndrome. But as coeliac disease gets worse, tiredness and fatigue may also set in, because the body isn’t able to extract enough iron. Others may notice swelling in various parts of the body due to fluid retention, because the gut cannot excrete water in the normal way.
So getting a diagnosis and learning how to manage the condition is important in part to avert the presence of these symptoms; but it’s perhaps more important in limiting the risk of complications.
To explain, if someone who cannot tolerate gluten carries on eating it, long-term damage and serious illness may result in the gut. Someone who can’t sufficiently soak up vitamins and minerals from food may not only become iron deficient, but also develop anaemia and osteoporosis.
Doctors assess whether coeliac disease is present by undertaking a blood test, and looking for specific antibodies. Those who present a positive result will then be referred to a gastroenterologist for a biopsy.
For those who have been newly diagnosed, getting to grips with a new set of dietary requirements can seem like a daunting challenge at first. It pleases me to say that there are, however, more options available now for those who can’t eat gluten than there ever have been before. Most large supermarkets have gluten-free sections, and many manufacturers specialise solely in producing foods which cater to coeliac’s too. Online magazines like this one are also a great resource for recipes and product reviews.
Remember that if you need further guidance, you can always speak to your GP or dietician.
I hope that’s a help!
Thanks again Erika.