If you are in doubt, get tested and look out for the following symptoms:
The symptoms can be subtle, and you may feel unwell for some time for no reason before the diagnosis is made. It used to be thought that coeliac disease affected about 1 in 1500 people. More accurate diagnosis through blood tests has shown that the condition affects up to 1 in 300 people in the United Kingdom, Europe and the USA. It is more common in some areas of the world, particularly on the west coast of Ireland, where 1 in every 100 people are thought to have coeliac disease. Coeliac disease can affect you at any age. It was thought to be more common in men, but probably occurs equally in men and women. One definite risk factor is a history of the condition in your family. Coeliac disease occurs in people who are genetically prone to it. If you have a parent, sibling or child with coeliac disease, you have a 10 per cent chance of also developing it. If you have an identical twin with coeliac disease, your chances increase to more than 70 per cent.
Coeliac disease has many and varied symptoms, and symptoms in adults are different to those in children.
In childhood symptoms do not appear until gluten-containing foods are introduced into the diet.
- Poor appetite, irritability and a failure to gain weight are usually the first symptoms.
- Pale, bulky stools that smell nasty.
- Vomiting and diarrhoea, which can lead to a wrong diagnosis of gastroenteritis.
- Swollen stomach.
- Arm and leg muscles may become wasted and thin.
- weight loss with pale, offensive diarrhoea
- abdominal bloating with wind.
- extreme tiredness – which is a sign of anaemia
- psychological problems like depression
- bone pain and sometimes even fractures – which are due to thinning of the bones
- ulcers in the mouth
- a blistering, itchy skin rash mostly on the elbows and knees, called dermatitis herpetiformis.
In one neurology clinic, several patients who, for no apparent reason, had difficulty walking and coordinating (ataxia) were tested for coeliac antibodies in the blood. A significant number were found to have coeliac disease, although many of them did not have any gut symptoms. Your doctor may also want to know whether you have lost weight or whether you have symptoms of anaemia (tiredness, exhaustion, pallor). The doctor may:
- examine your abdomen
- look for a blistering rash on your skin
- check for mouth ulcers
- Your doctor will check for anaemia, testing the levels of iron, folic acid and calcium in your blood
Another blood test detects antibodies that are often found in coeliac disease. Several antibodies are linked to the condition, but the most specific is anti-endomysial antibody. If this is present in the blood, you are very likely to have coeliac disease.
An endoscopy test is often used to diagnose coeliac disease. Your doctor should arrange this test at the endoscopy unit at your local hospital.