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What Is Coeliac Disease?
Coeliac disease is an inflammatory gut reaction to the ingestion of gluten (the "gluey" factor in many grains), that causes damage to the small intestine mucosa. The intestine walls are furnished with thousands of finger-like protrusions called villi. Their function is to maximise absorption of nutrients by increasing the surface area of the intestinal walls.
Amaong other things the effect of gluten on the intestine is to cause these villi to atrophy and shrink, so much of the absorptive power of the intestines is lost.
Causes of Coeliac Disease
There is a strong genetic component in coeliac disease and an association with other immune disorders such as juvnile diabetes and thyroid disease. Gluten can bwe found in wheat, barley, rye and oats. There is conflicting evidence on the injurious nature of oats.
There is little information on the triggers for coeliac disease, but possibilities are gastrointstinal surgery, pregnancy, high-dose gluten challenge, and viral infection.
Classic Symptoms
Classic symptoms include weight loss, bloating, flatulence, multiple deficiencies, and steatorrhea. Atypical symptoms include other gastrointstinal complaints such as diarrhoea, constipation, abdominal pain, milk intolerance, as well as fatigue, depression, arthralgia, osteomalacia, osteoporosis, and anaemia. Coeliac disease is common in many ethnic groups and serological survys indicate an occurrence of 1 in 250-500 people in most countries studied including the United States and most European countries. Dermatitis herpiformes, an itchy skin rash is also a reasction to gluten and is gnerally associatd with coeliac disease.
Treatment
The treatment for coeliac disease is strict adherence to a gluten-free diet, and anyone associated with a sufferer from the disease needs to become aware of the necessity of reading the ingredients lists on any ready-prepared foods purchased.
The widening spectrum of Coeliac disease.
Am J Clin Nutr 69 (1999)
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