| Welcome. This section is for those of you who have been diagnosed as “celiac (coeliac) disease (abbreviated CD). Out of every 100 people, one person has CD. You are one of the lucky ones because you have been found. Did you know that most people with CD have not been detected? For each person diagnosed, another 8-10 are still getting mystery symptoms.
Lots of people are wondering if they are getting sick from gluten. They are wondering if they might have CD. In this section you can find out the basics about CD. The Doctor Gluten Project is your online resource to provide you advice and leading edge information. It has been created to assist people who are gluten sensitive and/or wheat intolerant or who suffer from Celiac Disease or the Gluten Syndrome.
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Coeliac disease is a tissue diagnosis of gut damage caused by gluten. If you have had the small bowel biopsy (by endoscopy), then you have started off well. But the diagnosis is only the beginning. It is a matter of keeping well and on a strict gluten-free diet, life-long. I hope that I can help you on your journey of attaining full and vibrant health again over the next few years. Do join our Doctor Gluten Expert Forum. Become part of the global community of people who have kicked the gluten habit. You can help yourself and others throughout the world. |
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Although Coeliac Disease is usually viewed as a gastroenterological condition, I challenge this notion.
The usual definition of Coeliac Disease is: a gastrointestinal disease where there is damage to the small intestinal muscosa (skin) from the toxic effects of gluten from the diet. It is associated with a positive tTG antibody test and villous atrophy on upper small bowel biopsy. It is reversible on a gluten-free diet. It occurs in genetically susceptible people (re the HLA typing).
However, it is my opinion that gluten-sensitivity (the Gluten Syndrome) should be viewed in a much wider context. The evidence is that CD is primary a neurological disorder (see my book: “Full of It!”). |
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The symptoms of Coeliac Disease are extremely wide-ranging. The symptoms are indistinguishable from The Gluten Syndrome. The “classic” picture of chronic diarrhoea, and failure to thrive is an unusual presentation nowadays. Indeed, about 5% of new CD people are obese. In adults, the most common presenting features are iron deficiency, tiredness and “irritable bowel”. Check out the symptoms list. Classic symptoms - Children? When babies start to eat cereals they may: - Become listless, miserable and irritable
- Go off their food and lose their appetite
- Grow poorly (poor weight gains, called failure to thrive)
- Have short stature (poor height gains)
- Have diarrhoea (often with bulky, pale, smelly bowel motions)
- Have muscle-loss, particularly around the buttocks
- Have `pot-bellies’ due to abdominal distension
- Have nutritional deficiencies (low iron, anaemia, hair thinning)
- Have immuno-deficiency (more illness and infections)
- Poor muscle growth (weakness and developmental delay) muscle wasting)
- Poor bone growth (osteoporosis)
Classic symptoms – Adults? Often, in adults, intestinal symptoms may be absent. In some patients, symptoms caused by malabsorption (the poor absorption of food) are the main complaints. However, the predominant feature may not be the gut. The classic symptoms in adults include: - Diarrhoea or constipation.
- Tiredness and fatigue.
- Anaemia.
- Mouth ulcers and sore tongue.
- Heartburn, abdominal pains, bloating.
- Weight loss.
- Infertility.
- Bone pain from osteoporosis.
- Weak muscles (myopathy).
- Damaged nerve function (neuropathy).
- Dermatitis herpetiformis (an itchy vesicular rash).
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No! Whatever test that you have had, if it was “normal” you cannot exclude coeliac disease. All that you can say is that, at the moment, you do not have coeliac disease. How can this be true? |
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The diagnosis of CD starts with suspicion from symptoms or family history. The next step is the blood tests (see next part). Then the small bowel biopsy by endoscopy. At the moment, a definitive diagnosis of CD cannot be made without the demonstration of small bowel damage (villous atrophy). A new test called DGP (Deamidated Gliadin Peptide) might make a big difference to this. There are so many millions of people with celiac disease in the world, that it is impractical to organise an endoscopy of every single affected person. |
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The coeliac blood test markers have been progressively developed over the last 20 years. This has changed the understanding of gluten sensitivity. These coeliac markers are divided into two groups. They measure quite different phenomena: Gluten tests The anti-gliadin antibodies (abbreviated as AGA) are antibodies that are directed against gluten or gliadin in the diet. Gliadin is a specific protein that is part of gluten. There are two types of AGA: IgG antigliadin and IgA antigliadin antibodies. These antibodies are made against wheat protein. Tissue tests The Endomysial antibody (abbreviated as EMA) and tissue-transglutaminase (abbreviated as tTG) are directed against the damaged endomysial muscle in the tissue of the bowel. These antibodies are made against gut muscle tissue protein. |
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When do symptoms of Coeliac Disease first appear?
Gluten symptoms slowly get more severe as time goes on. Symptoms can often begin soon after gluten appears on the child’s diet. But the tissue damage in the gut may takes years and years to become established. Some people are diagnosed at 12 months of age, other at 90 years of age. Because the symptoms are so varied, including mental and psychiatric problems, the possibility of CD need to be born in mind for everyone with ongoing symptoms, at any age. Remember, you cannot rule out CD, all you can do is confirm it. |
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