Explainer: What is coeliac disease – and how does it differ from gluten intolerance?
Tens of thousands of people in Ireland are living with coeliac disease. However, according to the Coeliac Society of Ireland, it is a significantly underdiagnosed condition. By their estimation, for every person diagnosed with coeliac disease, there are between 5 to 10 others who are living undiagnosed. Prevalence is around 1 in 100 Irish people.
What is coeliac disease?
Coeliac disease is caused by an adverse reaction in the small intestine to gluten. Gluten is a protein found in the cereals wheat, barley and rye. Gluten is commonly found in food like bread and pastry, pasta, rice and noodles, as well as things that may have added flour such as sauce, pancakes, crackers and so on. It can also be found in drinks such as beer.
Who is affected by it?
Women are more likely to be affected by the condition. It can develop at any stage of life, but most cases are diagnosed in children or in later adulthood, between 40 and 60 years of age. Certain conditions – such as Down’s syndrome and type 1 diabetes – increase the likelihood of a person having coeliac disease. You’re also encouraged to get tested for coeliac disease if a member of your close family has it.
What are the symptoms?
One key symptom of coeliac disease is something called ‘steatorrhoea’. This means that your body is not absorbing nutrients from your food properly, leading to bowel movements that contain a lot of fat – which means they are likely to be oily, pale, difficult to flush and unusually foul-smelling.
Other symptoms include:
- Abdominal pain
- Bloating and flatulence
- Weight loss
In children, this may result in unusually slow development or growth, which may include a delayed puberty.
Are there any complications that can arise from coeliac disease?
As mentioned, many cases of coeliac disease go undiagnosed – and therefore untreated. This may lead to complications if the affected person continues to eat gluten. This shows the importance of getting checked if you’re concerned.
Long-term issues include:
- Anaemia (iron deficiency)
- Vitamin B12 deficiency
- Bowel cancer
- Pregnancy complications
How does it differ to gluten intolerance?
Coeliac disease is an autoimmune disease. This means when a coeliac eats food containing gluten, their body’s immune system attacks itself and causes harm to the lining of the digestive system. It is often hereditary.
An intolerance, however, is quite different. It does not carry any of the more serious complications linked to coeliac disease, for example, nor is it linked to other autoimmune issues such as diabetes.
Gluten sensitivity is a more debated topic and many people may fall along a broad spectrum of intolerance to gluten. However, the key difference is that it is not an autoimmune reaction and therefore is frequently more easily managed for those affected.
What can I do to manage my coeliac disease – or help loved ones with it?
Unfortunately, there is no cure for coeliac disease. Changing diet to cut out all foods that contain gluten is the easiest way to manage the symptoms.
If you have a friend or loved one with coeliac disease, it’s important to be mindful of their dietary requirements when eating together, as even a small amount of gluten for those severely affected can have significant consequences. Depending on severity, this may extend to things such as sharing toasters, due to the crumbs inside. Always ask if you are not sure, as the person with coeliac disease will be able to advise you of their needs.
If you’d like more information and support on coeliac disease, check out the Coeliac Society of Ireland. Their website also offers an online self-assessment tool as a starting point. Contact your GP to discuss your symptoms if you think you may have coeliac disease.
For more advice from Vhi on living a healthy life, click here.