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Immunology => Histocompatibility Groups => Coeliac Disease
Coeliac Disease
Coeliac Disease, also known as gluten enteropathy, inability to digest the protein gluten that is found in foods containing wheat or rye. Hypersensitivity to gluten causes repeated damage to the lining of the small intestine and consequent failure to absorb food nutrients. Iron-deficiency anaemia and weight loss often result; stools (faeces) are fatty and bulky, and there is severe flatulence. Sometimes there are no symptoms.
The hypersensitivity is thought to be a response of the immune system to the gluten, as though it were an infective agent to be overcome. While relatively rare, coeliac disease is far more common in Western countries, although there is considerable variation from one country to another (it is nearly eight times as common in the Republic of Ireland as it is in the United Kingdom). It tends to run in families, and can start as early as infancy with the introduction of wheat-containing foods. Babies with coeliac disease suddenly become extremely ill with diarrhoea, vomiting, and a distended abdomen. In adults, symptoms develop over years; the weight loss, abdominal pain, and diarrhoea associated with the disorder are often mistaken for other problems, and it may take a series of medical tests to confirm a diagnosis. These include taking three biopsies of the small intestine. The patient is tested while on a gluten diet, then a gluten-free diet, and finally, a gluten diet once again. Tests on blood and urine confirm failure to absorb nutrients.
Treatment is to eat a diet totally free of all foods containing wheat, barley, rye, and sometimes oats. This ensures the return of normal digestion, and weight gain. Usually pasta, rice, dairy products, fruit, vegetables, fish, and meat cause no problems. Gluten-free foods (such as rice crackers), which in the United Kingdom have a special symbol, may be prescribed in the same way as National Health Service drugs.
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