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Coeliac disease is characterised by permanent intolerance to gluten and chronic inflammation of the small intestinal 1,2. When gluten is eaten the lining of the small intestine flattens which means food cannot be absorbed properly 1. This can lead to a range of other symptoms including iron-deficiency anaemia and osteoporosis. The inflammation is reduced when a gluten-free diet is followed. Gluten is found in wheat and rye, with similar proteins also found in oats and barley. Symptoms of coeliac disease include abdominal pain, weight loss, diarrhoea, tiredness, vomiting, constipation, IBS type symptoms, bloating and poor growth in children 3,4.
Coeliac disease is diagnosed by a blood test that measures the IgA antibodies that are produced when gluten is eaten. Blood tests can provide up to 99% accuracy of diagnosis 4. After a positive blood test a biopsy (sample of body cells taken and looked at under a microscope) is needed to look at the lining of the small intestine and confirm diagnosis.
Coeliac disease is a condition known throughout the world, occurring in 1-2% of the population (1-2 cases per 100 people)2.
Research suggests that the average occurrence of coeliac disease in Western populations is 1 out of 100 people (1%).2 Studies from the UK 9,10,11,12 show a range prevalence ranges from 0.3%- 3%.
Under diagnosis and misdiagnosis of coeliac disease are known to be common and as routine screening is not carried out for coeliac disease there are currently many non-diagnosed cases 9.
1 in 100 children in the UK have been found to have coeliac disease, which is similar to the figures found for the adult population 13.
Studies conducted in the United States show a frequency of coeliac disease ranging from 3 per 1000 to 9.5 per 1000 people (0.3%-0.95%)8,14,15. In Northern Ireland the occurrence was found to be 4 per 1000 to 12 per 1000 people (0.4 -1.2%)10.
The risk of coeliac disease is increased in first degree relatives by up to 20%, in those with osteoporosis 1-3% and those with type 1 diabetes 3-6% 16. There is also a higher prevalence in populations with Downs Syndrome, Turner sydrome, Williams syndrome, selective IgA deficiency and autoimmune disorders 11.
The following references have been used in this article
| Ref # | Reference Name | Date Published | Author(s) |
| 1 | American Gastroenterological Association medical position statement: guidelines on osteoporosis in gastrointestinal diseases (1) - Gastroenterology 2003 Mar;124(3):791-4 | 2003 | [10038] American Gastroenterological Association |
| 2 | Is intestinal biopsy always needed for diagnosis of celiac disease? - American Journal of Gastroenterology (2004) 98 (6): 1325-1331 | 2004 | [10069] Scoglio R, Di pasaquale G, Pagano G, Lucantoo MC, Maguzzu G, Sflerlazzaz C |
| 3 | A comparison of antibodies to tissue transglutaminase with conventional serological tests in the diagnosis of coeliac disease - Eur J Gastroenterol Hepatol (2004) Jul;16(7):715-6 | 2004 | Johnston SD, McMillan SA, Collins JS, Tham TC, MCoeliac Diseaseougall NI, Murphy P |
| 4 | Antiendomysial and antihuman recombinant tissue transglutaminase antibodies in the diagnosis of coeliac disease: a biopsy-proven European multicentre study - Eur J Gastroenterol Hepatol 2005;17:85-91 | 2005 | [10071] Collin P, Kaukinen K, Vogelsang H, Korponay-Szabo I, Sommer R, Schreier E, Volta U, Granito A, Veronesi L, Mascart F, Ocmant A, Ivarsson A, Lagerqvist C, B |
| 5 | North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Guideline for the diagnosis and treatment of celiac disease in children - J Pediatr Gastroenterol Nutr 2005 Jan;40(1):1-19 | 2005 | [10041] Hill ID, Dirks MH, Liptak GS, Colletti RB, Fasano A, Guandalini S, Hoffenberg EJ, Horvath K, Murray JA, Pivor M, Seidman EG; |
| 6 | Celiac Disease - World J Gastroenterology 2006; 7 12 (41): 6585-6593 | 2006 | [10066] Rodrigo L |
| 7 | Adult coeliac disease - BMJ 2006; 335: 558-562 | 2006 | [10068] Hopper AD, Hadjivassiliou M, But S, Sanders D S |
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