Coeliac Disease

 

What is coeliac disease?

In people with coeliac disease (pronounced ‘seel-ee-ak’ and spelt celiac in some countries) the immune system reacts abnormally to gluten (a protein found in wheat, rye, barley and oats), causing small bowel damage. The tiny, finger-like projections which line the bowel (villi) become inflamed and flattened. This is referred to as villous atrophy. Villous atrophy reduces the surface area of the bowel available for nutrient absorption, which can lead to various gastrointestinal and malabsorptive symptoms. Symptoms can also be caused by inflammation in other parts of the body.


Healthy Villi                                Damaged Villi

A number of serious health consequences can result if the condition is not diagnosed and treated properly.

 

Who gets coeliac disease?

Coeliac disease affects people of all ages, both male and female.

You must be born with the genetic predisposition to develop coeliac disease. The most important genes associated with susceptibility to coeliac disease are HLA DQ2 and HLA DQ8. Either one or both of these genes are present in virtually every person with coeliac disease. While 30% of the population carry one or both of these genes, only 1 in 30 of these people (approximately) will get coeliac disease.

A first degree relative (parent, sibling, child) of someone with coeliac disease has about a 10% chance of also having the disease. If one identical twin has coeliac disease there is an approximate 70% chance that the other twin will also have coeliac disease (but may not necessarily be diagnosed at the same time).

Environmental factors play an important role in triggering coeliac disease in infancy, childhood or later in life.

 

How common is the condition?

Coeliac disease affects on average approximately 1 in 70 Australians. However, approximately 80% currently remain undiagnosed. This means that approximately 330,000 Australians have coeliac disease but don’t yet know it.

More and more people are being diagnosed with coeliac disease. This is due to both better diagnosis rates and a true increase in the incidence of coeliac disease.

 

Can coeliac disease be cured?

People with coeliac disease remain sensitive to gluten throughout their life, so in this sense they are never cured. However, a strict gluten free diet does allow the condition to be managed effectively.

A strict, lifelong gluten free diet is currently the only recognised medical treatment for coeliac disease. By removing the cause of the disease, a gluten free diet allows the small bowel lining to heal and symptoms to resolve. As long as the gluten free diet is strictly adhered to, problems arising from coeliac disease should not return. Relapse occurs if gluten is reintroduced into the diet.

 

What are the long term risks of undiagnosed and untreated coeliac disease?

The long term consequences of untreated coeliac disease are related to chronic systemic inflammation, poor nutrition and malabsorption of nutrients. For more information, see Associated Conditions.

Fortunately, timely diagnosis of coeliac disease and treatment with a gluten free diet can prevent or reverse many of the associated health conditions.

 
 

Useful Links

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Brochures
Coeliac disease
Associated conditions
Fact sheets
Monitoring and follow-up
Why is the gluten free diet not helping me?
Position statement
Point of Care Testing for coeliac disease

 

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