What is Coeliac disease?

Coeliac disease is an inflammatory condition of the small intestine. Another name for coeliac disease is gluten sensitive enteropathy. The condition is caused by an abnormal immune response to dietary protein called gluten found in wheat, barley and rye. The abnormal response causes inflammation of the mucosa of the small intestine and flattening of the villous processes – these are the finger like projections of intestinal mucosa, which serve to increase the surface area and absorptive capacity of the small bowel. The condition causes symptoms which may be gut related or not. If it is not treated complications related to malabsorption of nutrients may occur e.g. inadequate uptake of vitamins and minerals from the diet.

The treatment of this condition is a ‘gluten free diet’. If the diet is adhered to symptoms resolve completely and complications of the condition are minimal. Even though a person becomes completely well on a gluten free diet they still have coeliac disease, which is a life long condition.

Incidence/prevalence?

Coeliac disease is most common in white European populations and runs in families. The condition occurs in genetically predisposed people. The risk of a person developing coeliac disease at some time in their life is 1 in 100 in the UK but in those with an affected close relative, such as a parent, or brother or sister, it is 1 in 10. The disease typically presents in childhood, but also presents in adults.

The onset of the disease is related to timing and amount of exposure to gluten in the diet. Since the 1970s weaning guidelines have postponed introduction of gluten-containing products from 3 months of age to at least 5 months of age and this may have reduced the incidence of coeliac disease in early childhood. The incidence of coeliac disease is 1 in 2500 to 1 in 3000 children per year with a median age of onset of 7 years.