Coeliac Disease

What is Coeliac Disease?

This is caused by intolerance to gluten and the related substance gliadin, proteins found in wheat. The person is sensitive to the gliadin fraction of gluten, the protein element of the wheat grain. It is a disorder of the small bowel (usually the first part, or jejunum) and the villi (the small tentacles that actually absorb the food elements), which are damaged and fail to carry out their normal duties. It may date from infancy, commencing soon after the baby is weaned and commences to take cereals. It is characterized by loose stools, failure to thrive, a “pot belly,” and general malnutrition.

The small bowel is affected. There are frequent loose stools and a failure to thrive, leading to general debility and a typical “potbelly.” It affects infants and children, symptoms often starting soon after weaning.

This condition is caused by a sensitivity of the lining of the small bowel to gluten, the protein portion of wheat. It may take years before diagnosis is made. Often it does not happen until a biopsy of the bowel lining is examined by the pathologist.

Coeliac Disease Symptoms

Wasting, irritability, and anaemia are common accompaniments. It occurs in approximately one in 4000 of the population, so is relatively common. If it occurs in older children or adults, there may not be such a typical history. However, close questioning will often indicate general vague ill health, and perhaps reduced rate of growth. Any of these symptoms definitely need medical investigation. Proof can be achieved by a biopsy of the bowel. This may be followed up by a test to see if symptoms disappear with the exclusion of gluten from the diet and the recurrence of symptoms once it is re-introduced.

Coeliac Disease Treatment

Treatment is surgical removal. This may require the construction of a false opening, termed a colostomy

A gluten-free diet is the usual recommendation. This brings about a remission of symptoms in 80 – 90 per cent of cases. Those who do not respond satisfactorily are probably not sticking systematically to the diet restrictions. Do-it-yourself kits are now available to detect gluten hidden in some foods. In many countries Coeliac Societies give excellent assistance to parents to help them make wise purchases, and offer help with dietary suggestions. Many parents find membership of this society extremely helpful.

Proper treatment is dramatically successful. When placed on a gluten-free diet the patient’s symptoms vanish, they gain weight and lose the potbelly. The success rate is close to 90 per cent.