Coeliac disease is a chronic (lifelong) disease located in the small intestine. It is triggered by gliadin, a part of certain corn proteins found in wheat, rye and barley. In everyday language these corn proteins are called "gluten". Oat can contain traces of gluten from other cereals and is therefore often included in the group of glutenous products.

Coeliac disease is partly hereditary, but not everyone with disposition to the disease develops symptoms. Other factors like an infection are believed to have to be present for the disease to develop. Because of the heritability more people within the same family often have coeliac disease.

It is estimated that up to 5000 Danes are coeliacs, whereas the number in other countries is somewhat higher. In Sweden it has been established that approx. 1 in 250 children is affected by coeliac disease and approx. 1 in 500 adults are affected, whereas the numbers in Denmark are approx. 1 in 1000. An early introduction of glutenous diets to babies can be a possible contributing factor to this variation.

The cause of the disease is found in the small intestine. When coeliacs eat glutenous food, the folded mucous membrane and cilia (hair-like projections) of the small intestine is damaged. The intestinal surface is reduced (it becomes more "flat") and food is poorly digested resulting in vitamins and other nutrients not being absorbed properly.

The surface of the small intestine will slowly heal in coeliacs eating gluten-free diet and the ability to absorb the nutrients will return to normal. However, it takes months before everything is back to normal and the process of healing takes longer with adults than children. If the glutenous diet is resumed the intestine will be damaged once again. It is therefore important that coeliacs eat a gluten-free diet for the rest of their lives.

The first symptoms often appear in childhood, but some only experience symptoms when in their teens or even in their forties. Even after the age of sixty you can develop the disease.

The symptoms of coeliac disease are increased flatulence, diarrhoea and undernourishment. Sometimes you will also see constipation, low haemoglobin percentage, joint pains, weight loss, fatigue and low spirits. Especially in younger children the symptoms can be bloated stomach, loose stools and inhibited growth due to the poor absorption of food nutrients. The extent of the symptoms can vary from light to severe.

If the disease occurs later in life, the symptoms are often less pronounced. In this case it can take years from the first symptoms appear till the diagnosis is established.

The diagnosis is established by examining a tissue sample from the mucous membrane in the small intestine. The sample is taken with a gastroscopy. In young children a damaged mucous membrane can also be a symptom of other diseases, and in these cases it is often necessary to take tissue samples several times, before the final diagnosis can be established.

Coeliacs eating a glutenous diet have an elevated level of antibodies against i.a. the corn protein gliadin. Today these antibodies can be measured in a blood sample and elevated levels of antibodies strongly indicate coeliac disease.

If there is a suspicion of coeliac disease it is important to eat plenty of gluten before having a blood sample taken. This way it is more likely that the blood sample provide a useful test result.

The measurement of antibodies is not a final proof of coeliac disease, but the result can be a guideline to whether a tissue sample should be taken from the small intestines. The level of antibodies in the blood will slowly return to normal values, when the diet no longer contains gluten.

The treatment of coeliac disease is a lifelong gluten-free diet that it is extremely important you keep to. This means that you are not allowed to eat wheat, rye, barley an in parts oats, as well as all foods containing glutenous cereals.

It can be difficult to know which foods contain gluten, since it is included in many foods under different names. It is therefore important to read the food declaration thoroughly before buying anything.

Source:

The Danish Coeliac Association
The Swedish Coeliac Association
The Danish Veterinary & Food Administration, "Cøliaki og mad uden gluten", 2003
Net-patient, Tema cøliaki, Steffen Friis, Dr. Med, 2005