Coeliac disease is characterised by an immune system reaction to the consumption of gluten, which is a type of protein found in wheat, barley, and rye. For patients with this condition, gluten triggers a response in the small intestine. Over time, this can damage the lining of the small intestine.

This condition also prevents the absorption of nutrients, and the aforementioned damage can lead to diarrhoea, weight loss, fatigue, anaemia, and bloating. In children, malabsorption results in serious consequences, including poor growth and development in addition to other symptoms.

This blog looks into the causes and condition management strategies for coeliac disease. Individuals who believe they may be suffering from this condition should seek immediate medical care.

Causes of coeliac disease

While it has been difficult for researchers to arrive at specific causes for this condition, the medical evidence shows that an individual’s genes, combined with their consumption of gluten, and other factors cause this condition.

Among the factors that may contribute to the onset of coeliac disease, breastfeeding, gastrointestinal infections, certain gut bacteria, certain surgeries, pregnancy, childbirth, viral infections and even severe emotional distress have been identified as significant.

Risk factors

Similar to other gastroenterological conditions, there are several risk factors for this condition. These include:

A family member with coeliac disease or dermatitis herpetiformis

Family history is a significant risk factor given that this disease can be passed through genetics. The closer the relative with coeliac disease, the higher the risk.

It is believed individuals with a family history of this condition are 10% more likely to develop it. The risk increases to 75% in the case of identical twins.

Childhood diets and sicknesses

It is believed that coeliac disease can develop if a digestive system infection such as the rotavirus infection occurs during early childhood.

It may also be likely that babies who consume gluten before they’re 3 months old may be at increased risk. Certain experts recommend that parents wait until a child is 6 months before being given food containing gluten.

There’s also evidence that babies may develop this condition if they’re not being breastfed when gluten is added to their diets.

Other medical conditions

Certain medical conditions like Type 1 diabetes, Down syndrome, Turner syndrome, autoimmune thyroid disease, microscopic colitis, ulcerative colitis, epilepsy, and Addison’s disease, can be associated with coeliac disease.

Treatment for coeliac disease

Dietary restrictions

Given that there is no permanent fix or cure for this condition, individuals need to maintain a strict, lifelong gluten-free diet. In this process, diets must be free from items like barley, semolina, triticale, malt, rye and other types of wheat and flour.

In addition to these, gluten may be incorporated in certain other food items, preservatives, supplements, toothpaste and mouthwash, and even certain lipsticks. In light of this, individuals must be discerning about the food and products they add to their lifestyle.

Mineral and vitamin supplements

Apart from dietary restrictions, incorporating vitamin and mineral supplements is also required if a patient’s anaemia or nutritional deficiencies are pronounced. Here, individuals must increase their copper, folate, iron, Vitamin B-12, D, and K, and Zinc intake.

Medication

Apart from dietary modifications, medication may be used to control intestinal inflammation as well. For patients whose small intestines are severely damaged or have refractory coeliac disease, course of steroids may be recommended. This type of medication can ease serious signs and symptoms of this condition.

Treating dermatitis herpetiformis

This is a type of skin rash that needs to be treated as a part of a patient’s condition management strategy if it emerges on a patient’s body.

Medication prescribed along with a strict diet will need to be maintained to treat this rash.

Treating refractory coeliac disease

For those with refractory disease, the small intestine may never heal. Because of this, specialised treatment and medical attention are necessary.

Coeliac disease treatment by an expert gastroenterologist

Coeliac disease is a lifelong condition that requires careful management. To do so, patients need ongoing guidance and support.

Dr Suhirdan Vivekanandarajah is an experienced interventional gastroenterologist and hepatologist in Sydney. Patients can receive further information and treatment for this condition from him.