I went to my GP because I have been feeling tired and developed an intensely itchy, blistering skin rash on my elbows, knees and buttocks. I was surprised when he suggested coeliac disease may be the cause of my problems. What is this?
Coeliac disease is a condition of the digestive system that damages the small intestine and interferes with absorption of nutrients from food. People who have coeliac disease cannot tolerate gluten, a protein in wheat, rye, and barley. While gluten is mainly found in foods, it can also be found in medicines, vitamins and even lip balms.
The condition is hereditary and can cause malabsorption of nutrients during childhood when nutrition is vital for normal growth and development. This can result in failure to thrive, delayed growth and short stature, delayed puberty and dental enamel defects. It may also be triggered for the first time by pregnancy, childbirth, viral infection, emotional stress or following surgery.
Symptoms can vary from person to person and can include abdominal bloating and pain, chronic diarrhoea, constipation or vomiting. Stools may be pale, foul-smelling or fatty, and there may be weight loss. Adults with coeliac disease are less likely to complain of digestive problems but instead experience iron-deficiency anaemia, fatigue and bone or joint pain. They may also suffer from osteoporosis, depression and anxiety, as well as infertility or recurrent miscarriage. Tingling and numbness in the hands and feet, seizures, mouth ulcers or an itchy skin rash called dermatitis herpetiformismay also be experienced.
People with coeliac disease may have no symptoms but can still develop complications of the disease over time. Long-term complications include malnutrition, liver diseases and cancers of the intestine.
How is it diagnosed?
Diagnosis can be made with special blood tests and a biopsy of the small intestine. Biopsy may also be needed of your rash to confirm it is related to coeliac disease.
How can it be treated?
Treatment for coeliac disease is a life-long diet free of gluten. For most sufferers, this type of diet will reduce symptoms and allow the intestinal damage repair. Improvement can often be noticeable within days of starting the diet.
The small intestine usually heals in three to six months in children but may take longer in adults. Referral toa dietitian is recommended for advice on food selection, label reading, and other strategies to help manage the disease.
