Coeliac Disease

How common is it?

Coeliac disease is a relatively common condition affecting 1% of the population. The incidence of coeliac disease increases by tenfold when there is a first degree relative affected by the disease. It is also more common in other associated medical conditions such as Williams syndrome, Turner syndrome, Down syndrome, diabetes and autoimmune thyroiditis.

What are the signs and symptoms?

Coeliac disease can cause iron deficiency anaemia, poor growth, mouth ulcers, osteoporosis, dermatitis herpetiformis, lethargy, abdominal distension, pale stool and poor dentition. A child with coeliac disease is sometimes miserable and withdrawn.

How is it diagnosed?

It is diagnosed initially by blood tests. Anti-tissue transglutaminase IgA is raised with positivity of anti-endomysial antibody IgA. The patient will then undergo gastroscopy to obtain small bowel tissue diagnosis (villi atrophy). If anti-TTG is greater than ten times the upper limit, the patient will undergo another repeat anti-tissue transglutaminase IgA. If both levels are greater than ten times the upper limit with positive anti-endomysial antibody, the patient can be diagnosed with coeliac disease without needing a gastroscopy.

What is the treatment?

Gluten is found in rye, barley and wheat. Coeliac disease patients will need to be on a gluten-free diet (<20ppm of gluten) for life. It is a lifelong condition, but it is not a life-limiting condition.

If you are sensitive to gluten but has negative coeliac anti-TTG level, you may have non-coeliac gluten hypersensitivity.