Bad gut feeling - Part One

Coeliac disease is a hidden condition that can lead to serious health problems. Classed as a chronic intestinal disorder caused by gluten in the diet, coeliac disease is an autoimmune disease, in which the body’s immune system attacks its own tissues. The gluten triggers a damaging immune response in the small intestine of sufferers, which leads to erosion of the gut lining.
 
According to researchers, coeliac disease occurs only in genetically susceptible individuals, and approximately one per cent of the population is affected, but most of those remain undiagnosed. It is also reported that it is twice as common in women.

The symptoms
The symptoms tend to vary from patient to patient, and in some instances people demonstrate no symptoms at all. However the common signs for coeliac disease tend to be weight loss, diarrhea and malnutrition. This tends to be as result of poor food absorption in the gut due to damage caused by gluten.

While these symptoms are still encountered, especially in children, the clinical presentation has changed over the last decade and they are no longer seen as frequently. Now, due to improved diagnostic methods and greater awareness of coeliac disease, symptoms unrelated to malabsorption are more common such as constipation, abdominal pain or discomfort, anemia, tiredness, depression, neurological problems or low fertility. Occasional symptoms are also recognised such as mouth ulcers and hair loss. Coeliac disease
is a multi-system disorder, so any part of the body can be affected.

The pattern in which the symptoms start can also vary. It can be sudden, sporadic, or gradual; some patients feel unwell for years before seeing a GP.


The causes
There is a strong genetic component to coeliac disease. However, factors such as type or quantity of gluten consumed or the age at which it is introduced are also considered as relevant. The balance of probiotic bacteria in the gut may be important, too, and there is evidence to suggest that coeliac patients have ‘leakier’ guts. Some patients are able to trace their symptoms to a trigger event such as pregnancy, gastroenteritis or surgery.

The typical new patient is a middle-aged female with subtle gastrointestinal symptoms, for example irritable bowel-type symptoms, perhaps with a history of feeling tired all the time.