Understanding Coeliac Disease: Symptoms, Causes, and Treatment Options
Coeliac disease is a chronic autoimmune disorder where the immune system attacks the small intestine in response to gluten, a protein found in wheat, rye, and barley. This reaction prevents the proper absorption of nutrients, leading to a variety of health problems. For those genetically predisposed with the HLA DQ2 and/or DQ8 gene mutations, consuming gluten triggers this harmful response. However, it's important to note that not everyone with these gene mutations will develop coeliac disease.
Who is Affected by Coeliac Disease?
Globally, the prevalence of coeliac disease is estimated to range from 0.2% to 2.4% of the population, but many cases go undiagnosed. In Australia alone, it’s believed that 75% of the 2% of people with coeliac disease remain unaware they have it. Women are twice as likely to develop coeliac disease than men, and while it can occur at any age, it often goes undetected in early life unless symptoms are severe.
Signs and Symptoms of Coeliac Disease
Coeliac disease presents with a wide range of symptoms, making it difficult to diagnose.
The most common signs are:
Chronic diarrhoea
Fatigue
Iron deficiency anaemia
Other symptoms may include:
Abdominal pain, flatulence, and vomiting
Chronic constipation
Distended abdomen
Weight loss or failure to thrive in children
Short stature or delayed puberty
Dental enamel loss and recurrent mouth ulcers
Osteopenia, osteoporosis, or bone fractures
Vitamin B12 and zinc deficiencies
Depression, anxiety, and recurring headaches
Skin conditions like dermatitis herpetiformis
Causes and Triggers for Coeliac Disease
Coeliac disease arises from a combination of genetic, immune, and environmental factors. The presence of gluten in the diet is the primary trigger, but other factors, such as early life feeding practices, birth method, infections, and antibiotic use, can also influence whether the condition develops.
Studies suggest that certain factors may offer some protection against autoimmune conditions like coeliac disease, including:
Vaginal birth
Breastfeeding
Lower antibiotic use in early life
Remaining relatively infection-free during infancy
Diagnosing Coeliac Disease
Accurately diagnosing coeliac disease involves specific testing, especially since its symptoms overlap with other gastrointestinal disorders. A series of blood tests and a biopsy are often required:
Coeliac Genotyping: To determine if the HLA DQ2 and/or DQ8 gene mutations are present.
Total Ig* and Tissue Transglutaminase IgA: Key markers for autoimmune response.
Deamidated Gliadin Peptide Antibodies: Indicative of gluten sensitivity.
Iron Studies, Vitamin B12, and Plasma Zinc: To assess for deficiencies.
C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR): Indicators of inflammation.
*Duodenal Biopsy: Performed via endoscopy, this is the gold standard for diagnosing coeliac disease by examining damage to the small intestine.
*Important Note: Individuals should continue consuming gluten—around four slices of wheat bread daily—for at least six weeks prior to testing, as eliminating gluten can lead to false negatives.
Treatment and Management of Coeliac Disease
The cornerstone of managing coeliac disease is a lifelong, strict gluten-free diet. This requires careful education about hidden sources of gluten and preventing cross-contamination.
Steps to Manage Coeliac Disease:
Complete Gluten Elimination: Removing all sources of gluten is essential to prevent symptoms and long-term complications.
Address Nutritional Deficiencies: Supplementing with iron, zinc, and vitamin B12 can help correct deficiencies common in coeliac patients.
Support Gut Healing: The damage to the small intestine’s microvilli needs time to heal. Natural remedies to soothe inflammation and repair the gut lining include:
Curcumin extract: Known for its anti-inflammatory properties.
Aloe vera extract and Slippery Elm: These help coat and heal the digestive tract.
Zinc carnosine and L-glutamine: Support repair of the intestinal lining.
Vitamin A, Vitamin D, and Quercetin: Essential for immune regulation and gut healing.
Marshmallow root extract: Provides soothing benefits for the gut.
Nutrient-Dense Whole Foods: Focus on a well-rounded, nutrient-dense diet that supports overall health. While many gluten-free processed foods are available, they are often low in nutritional value. Choosing whole foods ensures that nutrient absorption is optimised.
Living with Coeliac Disease
Navigating life with coeliac disease can be challenging, but with the right guidance, it’s possible to live a healthy, symptom-free life. Educating yourself on gluten-free options, avoiding cross-contamination, and addressing any nutritional gaps will help manage the condition effectively.
If you suspect you or someone you care about have coeliac disease or need help managing your condition, get in touch by booking a free clarity call.
