Coeliac disease is a life long condition affecting the small bowel of genetically susceptible individuals. Small bowel biopsy is essential to confirm the diagnosis.

Children frequently present with failure to thrive, vomiting, diarrhoea, muscle wasting and general irritability. 
 

Coeliac disease can however have a wide variety of monosymptomatic presentations these include osteoporosis, osteomalacia, female infertility and recurrent miscarriage. Coeliac disease is associated with a number of disorders of altered immunity including Dermatitis Herpetiformis, Systemic Lupus, Erythematosus, Scleroderma, Dermatomyositis and Sjogren’s syndrome.

Other associations include auto immune thyroid disease, Addison’s disease, IgA deficiency, Type 1 insulin dependent diabetes, decreased or absent splenic function, mouth ulceration, lymphocytic and collagenous colitis and auto immune liver disease. Patients with coeliac disease have an increase risk of gastro-intestinal malignancy particularly from lymphoma.

Screening blood tests can be used where the disease is suspected or if there is a family history.  However no blood test is 100% reliable and even if a screening test is positive or if a disease is suspected and a screening test has been negative   endoscopy and small gut biopsy is required.  

Treatment of coeliac disease involves a strict avoidance of gluten. This is far more complex than simply avoiding wheat flour. Gluten has elastic properties and is used as a filler in a variety of foods and even some medications. Dietary advice from a qualified dietician is essential.

 For full details on investigation treatments of Coeliac disease go to: assets/documents/Coeliac Text.pdf