Overview
Coeliac disease is a lifelong autoimmune condition in which eating gluten, a protein found in wheat, barley, and rye, triggers the immune system to damage the lining of the small intestine. This damage reduces the gut's ability to absorb nutrients, which can lead to a wide range of digestive and whole-body symptoms. It is not the same as a wheat allergy or non-coeliac gluten sensitivity. Untreated, it can cause nutrient deficiencies, weakened bones, and other long-term complications.
Symptoms
- Diarrhoea, sometimes pale, foul-smelling, or fatty
- Bloating, wind, and abdominal pain
- Fatigue and weakness
- Unintended weight loss
- Iron-deficiency anaemia
- Mouth ulcers
- An itchy blistering skin rash (dermatitis herpetiformis)
- In children, poor growth or delayed puberty
Causes & risk factors
- An autoimmune reaction to gluten in genetically susceptible people
- Specific genetic markers (HLA-DQ2 or DQ8)
- Family history of coeliac disease
- Sometimes triggered after infection, surgery, pregnancy, or major stress
Treatment & self-care
Care centres on a strict, lifelong gluten-free diet, which allows the gut lining to heal and symptoms to settle. Diagnosis should be confirmed by blood tests and usually a gut biopsy before removing gluten from the diet, so testing remains accurate. Ongoing support from a dietitian and monitoring for nutrient deficiencies and bone health are important. A licensed clinician should oversee diagnosis and follow-up.
See a doctor urgently if
- You have persistent digestive symptoms or unexplained tiredness
- You have unexplained iron-deficiency anaemia
- You have a close relative with coeliac disease and any symptoms
- You have ongoing symptoms despite a gluten-free diet
- You have unexplained weight loss