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Coeliac disease

What is coeliac disease?

Coeliac disease is an autoimmune condition caused by an adverse reaction to gluten.  When gluten is digested the body mistakes the substances that form the gluten protein as being harmful and begins to attack them.  This attack causes damage to healthy tissue within the small bowel, preventing the body from being able to absorb the vital nutrients it needs.1

It is unclear what causes the body’s immune system to react to gluten in this way.  Coeliac disease is commonly mistaken for an allergy or intolerance to gluten – this is not the case – it is an autoimmune condition.  It is also often misdiagnosed as IBS (Irritable Bowel Syndrome).  It affects around 1 in every 100 people in the UK and is more common in women than men.1

What causes coeliac disease?

Coeliac disease is caused by digesting foods that contain gluten – a dietary protein that is found in wheat, barley and rye.  These ingredients are commonly found in foods including bread, pasta, cakes, breakfast cereals and some processed foods such as ready-made meals and sauces.  When gluten is digested by coeliac sufferers the small intestine reacts by becoming inflamed and is then unable to absorb nutrients.1

What are the symptoms of coeliac disease?

Coeliac disease can result in symptoms such as abdominal pain, bloating, constipation, flatulence, indigestion and diarrhoea. These symptoms can lead to other concerns including weight loss, malnutrition, fatigue, skin and nerve problems, fertility issues and even delayed puberty in children.  Long-term, coeliac disease patients can experience complications including osteoporosis and anemia.1,2


Routine testing for coeliac disease isn’t carried out in the UK.  In order to be tested patients must present symptoms or have an increased risk of the disease due to family history.1

The testing process involves initial blood tests to establish if certain antibodies, usually present in the bloodstream of coeliac sufferers, can be identified followed by a biopsy to confirm to the diagnosis.  Patients will need to eat foods that contain gluten during the testing period.  A gluten-free diet shouldn’t be started until an official medical diagnosis has been made.3


Whilst there isn’t currently a cure for coeliac disease, dietary changes can help to manage symptoms.  Once a medical diagnosis has been made, you will be advised to move to a gluten-free diet.  It is important to ensure that your diet is healthy and varied as well as gluten-free.1  Gluten-free produce has become much more commonly available with a wide range of foods now offered in gluten-free options in most supermarkets.

It has been found that people with autoimmune thyroid disease have a higher risk of having coeliac disease so think about getting tested for coeliac disease if you have autoimmune thyroid disease and symptoms of coeliac disease.4–6

Many patients with autoimmune thyroid disease who have changed to a gluten-free diet have found that their thyroid antibodies have reduced and previously unresolved symptoms have abated.

Further information

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  1. NHS. Overview – Coeliac disease. NHS. Published December 3, 2019.
  2. Collin P, Salmi J, Hällström O, Reunala T, Pasternack A. Autoimmune thyroid disorders and coeliac disease. European Journal of Endocrinology. Published online February 1994:137-140. doi:10.1530/eje.0.1300137
  3. Ch’ng CL, Jones MK, Kingham JGC. Celiac Disease and Autoimmune Thyroid Disease. Clinical Medicine & Research. Published online October 1, 2007:184-192. doi:10.3121/cmr.2007.738

Date updated: 22.03.21 (V1.3)

Review date: 12.10.21

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