Celiac Disease
Also known as Coeliac disease, Gluten sensitive enteropathy
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is celiac disease?
Celiac disease is an autoimmune condition in which eating gluten triggers immune damage to the lining of the small intestine, impairing nutrient absorption. It is not an allergy or an intolerance. Testing must be done while the person is still eating gluten, because starting a gluten free diet first can make the diagnosis impossible to confirm.
Causes
- Immune response to gluten in wheat, barley and rye
- Genetic predisposition through HLA DQ2 or DQ8
- Damage and flattening of intestinal villi
Symptoms
- Diarrhoea, bloating and abdominal pain
- Weight loss and fatigue
- Iron deficiency anemia that does not respond to supplements
- Mouth ulcers
- An itchy blistering rash called dermatitis herpetiformis
- Delayed growth or puberty in children
- No digestive symptoms at all in some people
Risk factors
- First degree relative with celiac disease
- Type 1 diabetes
- Autoimmune thyroid disease
- Down syndrome or Turner syndrome
- Other autoimmune conditions
Diagnosis
- Tissue transglutaminase IgA antibody testing with total IgA
- Small bowel biopsy at endoscopy to confirm villous changes
- Testing performed while gluten is still being eaten
- Screening for iron, folate, vitamin D and calcium deficiency
- HLA typing in selected uncertain cases
Treatment
- Strict lifelong gluten free diet
- Dietitian input to ensure nutritional adequacy
- Correction of iron, folate and vitamin D deficiency
- Bone density assessment where indicated
- Follow up antibody testing to confirm dietary response
Self care
- Follow a strict gluten free diet for life
- Read labels carefully and learn hidden sources of gluten
- Prevent cross contamination with separate toasters, boards and utensils
- Ask about preparation when eating out
- Work with a dietitian to keep nutrition adequate
- Check that medicines and supplements are gluten free
- Join a coeliac organisation for reliable food lists
When to see a doctor
Book an appointment if:
- Symptoms persisting despite a strict gluten free diet
- New anaemia, weight loss or fatigue
- Bone pain or a fracture from minor injury
- Planning pregnancy
- Relatives wanting to be screened
- Before starting a gluten free diet, so testing can be done first
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Coeliac disease itself cannot be prevented
- Complications are prevented by strict lifelong gluten avoidance
- Screen first degree relatives, including those without symptoms
- Monitor iron, vitamin D, calcium and bone density
- Keep up with antibody follow up testing
Outlook
With a strict gluten free diet the intestinal lining heals, symptoms resolve and nutritional deficiencies correct, usually over months. Long term outlook is excellent for people who adhere well. Continued gluten exposure maintains inflammation and raises the risk of osteoporosis, persistent anaemia and, rarely, small bowel lymphoma.
Common questions
Should I go gluten free before being tested?
No. Removing gluten before testing allows the gut lining and antibodies to normalise, which produces false negative results. Continue eating gluten until testing is complete unless a clinician advises otherwise.
Is celiac disease the same as gluten intolerance?
No. Celiac disease is autoimmune and causes measurable intestinal damage and nutritional consequences. Non celiac gluten sensitivity causes symptoms without that damage and is diagnosed only after celiac disease is excluded.
How strict does the diet need to be?
Very strict. Even small repeated exposures can maintain intestinal inflammation, so cross contamination in shared kitchens and processed foods matters as much as obvious sources of gluten.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.