Coeliac disease is an intolerance to gluten, which means that the body cannot cope with gluten. In people with coeliac disease, the intestinal villi get destroyed when they regularly come into contact with gluten. This causes various abdominal problems, which can range from mild to severe. Coeliac disease is an autoimmune disease.
Gluten are grain proteins and are found in wheat, rye, barley, spelt, kamut and anything made with these grains. In case of coeliac disease, the immune system sees gluten as harmful, whereas they are not. Due to the reaction of the immune system to gluten, the mucosa of the small intestine is damaged and an inflammatory response occurs. As a result of the inflammation of the intestines, nutrients are poorly absorbed into the body.
The exact cause of coeliac disease is not known. Yet it is known that heredity plays a role. When the condition occurs in the family, there is a higher risk (ten percent) of getting it as well.
Coeliac disease can cause a lot of problems. The severity of the symptoms and whether someone gets the symptoms, varies from person to person. Examples of signs and symptoms are:
- Persistent diarrhea.
- Constipation, despite the use of laxatives.
- Fatty and smelly stools.
- Regular bloating and/or abdominal distension.
- Regular and longer than six weeks abdominal pain.
- Nausea and frequently vomiting.
- Weight loss for no clear reason.
- Regular and prolonged (six weeks) suffering from flatulence.
- Continuous and severe fatigue.
When coeliac disease is suspected, the doctor may order various examinations:
- Blood test. Coeliac antibodies are found in the blood of people with severe coeliac disease. However, this test provides no certainty, particularly in people with less severe forms of coeliac disease.
- Gastroscopy. This is an exploratory examination through the mouth, during which the doctor can take a tissue sample (biopsy) of the small intestine. Under the microscope is then assessed, whether the intestinal villi are damaged.
- Double-balloon endoscopy. This is an exploratory examination of the small intestine, with the aid of the patient’s own (peristaltic) movements of the intestine. In this way, the whole small intestine can be examined and a biopsy can be taken.
Coeliac disease cannot be cured and there are no medicines against this disease. The treatment of coeliac disease is to follow a lifelong gluten-free diet. If this diet is followed, the symptoms will slowly disappear. After a few weeks or months, the patient feels a lot better. The small intestine is completely restored within six months to a year. Following a lifelong diet is incriminating for many people, especially for children. The doctor sends the patient to a dietician for expert advice on a gluten-free diet. The dietician can help with compiling a proper diet.
As a result of coeliac disease, a person can possibly be weakened or have anemia. The patient is then advised to use extra vitamins and minerals for some time, such as vitamin B9 (folic acid), vitamin B12 and iron.
Coeliac disease is a chronic condition and may return when a person uses gluten again. If the disease is common in families, relatives of the patient should be examined to see whether they have the disease as well.
- Fortunately, there are many things that a coeliac patient is allowed to eat, such as rice, maize, soy products, fries which are fried in clean fat, sesame seeds, poppy seeds and yogurt.
- Ensure that food is not contaminated with gluten by others. Some bread crumbs can already cause problems and intestinal damage.
- The first step the patient needs to take, is to inform everyone in the environment that he or she suffers from coeliac disease and what that exactly means. The patient should also ask others to clean their kitchen stuff thoroughly after use.
- Care for, for example, your own breadboard, butter tub and jam jar and attach clear stickers, so that they should not be used by others.
- Coeliac disease was described for the first time in 1888 by the British pediatrician Samuel Gee. The Dutch pediatrician Willem Karel Dicke discovered the relationship with the consumption of breads and fibers in the forties of the last century.
- The term ‘coeliac disease’ is derived from the Latin word coeliacus (sick in stomach or intestines) and the Greek word koiliakos, from koilia, that means ‘abdomen, guts, stool’.
- The prevalence of coeliac disease is 1%.
- Women are twice more likely to have this condition than men.