Signs of coeliac disease

Symptoms of Coeliac Disease can include abdominal discomfort including bloating, unexplained weight loss, tiredness and frequent headaches. Coeliac disease can be difficult to diagnose as these symptoms are generic to a range of illnesses, or could be thought of as due to the everyday stresses of life.  Researchers have recently suggested that anaemia (low iron stores) may be an important indicator to check in adults, especially in those with a family history of coeliac disease. Unfortunately diagnosis may not occur until the gut wall has been damaged by malabsorption over many years of eating gluten containing foods.

An initial biopsy is required to confirm the extent of damage to the lining of the small intestine due to the disease. After a few months on a gluten-free diet a second biopsy is required to examine the repair process and improvement in the structure of the lining.

Coeliac Disease is more easily diagnosed in infants and children, as after eating gluten they become more tired and lethargic, with changes in bowel motions. In older children growth can be slowed and they can suffer from mineral deficiencies (low iron is common), abdominal pain or discomfort.

What are the health problems associated with coeliac disease?

Because of the damage to the small intestine and the reduction in nutrient absorption that occurs in people diagnosed with Coeliac Disease, some vitamin and mineral supplementation may be necessary to correct a deficiency or to improve intake.

The most frequent health problem experienced by people who suffer from coeliac disease is anaemia due to poor absorption. There are various types of anaemia due to a deficiency of iron, vitamin B12, folate or vitamin B6 and there may be only minor symptoms in adults.

A well-controlled gluten-free diet, the use of supplements and improved dietary intake providing plenty of these nutrients is recommended, with blood tests to monitor progress.

By far the greatest concern for people with coeliac disease as they age is bone health. Osteomalacia (weakening and softening of bone) results from the impaired absorption of vitamin D, and osteoporosis can occur due to impaired calcium absorption. People with osteoporosis appear to be 10 times more likely to have coeliac disease. Muscle cramps, due to poor absorption of calcium and magnesium are other possible health problems.

Where to get help

Proper diagnosis of Coeliac disease is important and if you have any concerns that you may suffer from this disease, you should make an appointment with your doctor. If you are diagnosed with Coeliac Disease then a visit with a dietitian is often recommended as they can give advice on how to change your diet to be gluten free.

For people with coeliac disease, the Coeliac Society of NZ is a useful source of information. They publish a regular magazine Coeliac Link which contains articles, recipes and information for people with coeliac disease. Email coeliac@xtra.co.nz for information.