Understanding Coeliac Disease

Coeliac disease, an extreme form of wheat allergy, is vastly under-diagnosed. Find out if you have it and what to do about it.

Confusing symptoms

Doctors are told that the signs and symptoms of coeliac disease, mostly emanating from the abdomen, are unmistakable: chronic diarrhoea/episodic diarrhoea with malnutrition, abdominal cramping, abdominal distention or bloating, foul smelling, bulky stools (steatorrhoea), weight loss or poor weight gain, and short stature. Expect to also hear complaints of weakness, fatigue and loss of appetite. However today we know that most people with coeliac disease no longer go to the doctor with abdominal symptoms. Instead, we are seeing patients first presenting with:
• Chronic psychological depression
• Overweight or obesity
• Abnormal elevation of liver enzymes of unknown cause
• Permanent teeth with distinctive horizontal grooves and chalky whiteness
• Chronic nerve disease of unknown cause (eg ataxia, peripheral neuropathy)
• Osteoporosis in women not responding to conventional therapies
• Intestinal cancers
• Insulin-dependent diabetes
• Thyroid disease (both overactive and underactive)
• Short stature in children

Undetected gluten sensitivity

Whether or not it has led to coeliac disease – gluten sensitivity is commonly found among pre- and post-menopausal women and even children who suffer from osteoporosis. The same nutrient deficiencies found in osteoporosis – calcium, magnesium, vitamin D and vitamin K – are also seen in people suffering from coeliac disease. In fact, one recent study showed that a gluten-free diet actually reversed osteoporosis in people with coeliac disease. Researchers took 44 coeliac patients, who were aged from two years to 20 years old at the time of their diagnosis, and compared them to 177 healthy, coeliac-free people.

The lumbar spine and whole-body bone mineral density values of people with coeliac were significantly lower than those without the disease. But after one and a half years on a gluten-free diet, the coeliacs were retested and found to have bone density that had improved so much it was almost indistinguishable from those of the non-coeliacs. [1]

Diabetics at greater risk

Almost half of all people with type-1 diabetes have ATG antibodies, which are a diagnostic marker of coeliac disease, and the majority have deposits of these antibodies in their intestines. [2] A survey in Denmark found that one in eight children with type-1 diabetes also had coeliac disease. [3] This suggests that the early introduction of wheat products might increase risk. 

Cancer and coeliac disease

Undetected coeliac disease is associated with a 40 to 100 fold increased risk of intestinal lymphomas. [4]

This is because the immune system of a person with this condition doesn’t fight against cancer cells as well as it should. More than 80 international studies have been published on the increased incidence of cancer in coeliac disease. In the case of intestinal lymphomas – the most common kind of cancer associated with coeliac – by the time they have been identified, the prognosis is generally very poor. On the other hand, if coeliac disease is diagnosed before cancer becomes clinically evident and a gluten-free diet is strictly followed, the risk of intestinal lymphoma decreases from...

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