Dr Vered Schildkraut
Paediatric Gastroenterologist
Coeliac Disease
For more information:
https://naspghan.org/files/documents/pdfs/medical-resources/celiac/CeliacGuidelineSummary.pdf
https://www.nhs.uk/conditions/coeliac-disease/
What is coeliac disease?
Coeliac disease is a condition where the body’s immune system reacts to gluten.
Gluten is a protein found in foods made with: • Wheat • Barley • Rye
WHAT ARE THE USUAL SYMPTOMS OF COELIAC DISEASE?
There is a wide variation in the symptoms experienced. Common symptom are diarrhoea with bloating or discomfort in the abdomen. In children, vomiting or a failure to thrive may be the only presenting symptoms. Coeliac disease is often suspected when a child has iron deficiency anaemia, unexplained weight loss and/ or is just feeling unwell. Often, patients don’t have GI symptoms at all.
How is it managed?
The only treatment is a strict, life-long gluten free diet. Eating any gluten causes the small, finger-like projections (villi) in the bowel to become inflamed and flattened. Eating a gluten free diet allows the bowel wall to heal and digestion to return to normal.
What are the risks of not following a strict gluten free (GF) diet?
Small bowel damage leads to poor absorption of nutrients causing iron deficiency anaemia, other vitamin and mineral deficiencies, osteoporosis, weight loss, in addition to gastrointestinal symptoms e.g. diarrhoea, nausea, bloating.
HOW IS COELIAC DISEASE DIAGNOSED?
• Blood tests ("coeliac serology"): these will be looking for antibodies indicative of coeliac disease and must be done whilst gluten containing food is still being eaten.
• The no-biopsy approach: diagnosis may be considered by the gastroenterologist based on the levels of coeliac antibodies in two separate samples.
• Endoscopy: biopsies of the small bowel.
CAN COELIAC DISEASE BE DIAGNOSED BY HLA TESTING?
No. A negative test for HLA-DQ2 and/or HLA-DQ8 indicates that Coeliac disease is unlikely, while a positive result does not confirm the diagnosis.