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Coeliac disease (coeliac sprue or gluten allergy)
Written by Dr Jocelyn S Fraser, specialist registrar in gastroenterology
What treatment is available?
It's not possible to prevent coeliac disease, but a gluten-free diet can reverse damage to the small intestine. This requires considerable discipline.
After diagnosis your GP should refer you for a consultation with a dietitian, who can give you diet sheets and advice.
Another important aspect of treatment is replacing vitamins and minerals. You may need iron tablets, folic acid supplements (especially when pregnant or planning to get pregnant) and calcium.
Severe coeliac disease that does not get better on a gluten-free diet may need tablets that 'damp down' the immune system, such as steroid tablets. This is rare.
Avoiding gluten does not cause serious side-effects. However, gluten-free food does tend to be low in fibre and can cause constipation in some people. To counteract this, eat plenty of fruit and vegetables.
If constipation persists, try rice bran or a laxative called Fybogel, which is available with or without a prescription from your pharmacy.
What is a gluten-free diet?
Oats have generally been shown not to upset people with coeliac disease, but are probably best avoided. This is because oats may contain a small amount of gluten, and are often processed and stored in the same mills as wheat. This means they can be contaminated with gluten.
Some medicines contain gluten, so you must check with your doctor or pharmacist before taking them.
Foods you can eat
Gluten-free substitutes are available from most supermarkets and pharmacies. You can also get staples such as gluten-free flour, breads, biscuits and pasta on prescription from your doctor.
There are excellent books available on gluten-intolerance, including general guides and recipe books.
What complications can coeliac disease cause?
Coeliac disease is an autoimmune disease.
Is there a cure for coeliac disease?
This means the disease can be 'cured', but only by avoiding foods that contain gluten. If you do this, you can enjoy a good quality of life without symptoms or long-term complications.
Support groups
Many foods do not contain gluten, including:
Complications of coeliac disease are rare. They include the following.
A gluten-free diet should enable the lining of the bowel to return to normal in most people. But damage will return as soon as you start eating gluten again.
Coeliac UK can offer all kinds of advice and operates a helpline 0870 444 8804.
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