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The range of symptoms associated with coeliac disease means that it is not easy to diagnose. Coeliac disease is usually suspected when someone has severe abdominal symptoms and also shows signs of malnourishment or anaemia.

Coeliac disease can be more firmly diagnosed using:

  • Family history: some genes make people more likely to develop coeliac disease, however, 20% of Europeans who have these genes never develop the disease.
  • Blood tests: tests that include specific and sensitive antibodies called tissue transglutaminase or anti-endomysial antibodies can be used to detect the majority of coeliacs.
  • Endoscopy: this is done to examine the small intestine using a camera. A biopsy taken from the intestinal wall is examined under a microscope. The tiny projections called villi on the inner surface of the intestine are characteristically short in people with coeliac disease and the lining contains an excess of inflammatory cells.

If you are diagnosed with coeliac disease there is no instant cure or even a specific treatment.

It is possible to treat the symptoms of the disease and the first step is to remedy any nutrient, vitamin, or iron deficiency that has developed. Pain relief can be given during severe attacks of abdominal pain.

Prevention is also important; the only way to prevent symptoms of coeliac disease is to avoid foods that contain gluten. This is difficult as many foods contain gluten but fortunately, with wider awareness of the condition, many restaurants now cater for people with coeliac disease.

Refractory coeliac disease

In some cases, removing gluten from the diet does not remove the symptoms of coeliac disease. This form is defined as refractory coeliac disease, which is usually treated by corticosteroids until the worst of the symptoms subside. Sticking to a gluten-free diet is then still essential as ingesting any gluten can bring on a relapse and can increase the risk of long-term damage of the intestinal wall.

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