Abdominal discomfort, bloating or irregular bowel movements are problems that affect many people. These symptoms can be signs of a number of digestive disorders, including coeliac disease. Recognising and managing gluten-related disorders is key to improving quality of life. Many people are wary of undergoing tests, but modern medicine now offers gentle methods for establishing an accurate diagnosis.
This article provides a comprehensive guide to the symptoms of coeliac disease, diagnostic procedures and the most effective treatments. Our aim is to help you understand this condition and allay any fears you may have about the diagnostic process, so that you too can begin your journey to recovery. The Endomedix Gastroenterology Centre Our specialists are committed to helping their patients using the most up-to-date and gentle procedures.
What is gluten sensitivity?
Gluten is a protein complex found in wheat, barley and rye. Gluten-related disorders can take several forms, and it is important to distinguish between them.
- Coeliac disease: This is an autoimmune disease in which the consumption of gluten triggers an immune response, leading to damage to the lining of the small intestine and the atrophy of the villi. This damage causes malabsorption, which can lead to nutrient deficiencies and serious health problems.
- Wheat allergy: This is a classic food allergy, in which the immune system reacts to the proteins found in wheat. Symptoms usually appear quickly, within minutes or hours of eating, and may include skin symptoms (hives), respiratory symptoms (sneezing, shortness of breath) or gastrointestinal symptoms (vomiting, diarrhoea).
- Non-coeliac gluten sensitivity (NCGS): In this case, consuming gluten triggers symptoms similar to those of coeliac disease (bloating, abdominal pain, fatigue), but does not cause damage to the villi, and the autoantibodies characteristic of coeliac disease cannot be detected in the blood. The diagnosis is based on ruling out other conditions.
What symptoms might indicate gluten sensitivity?
The symptoms of gluten sensitivity can vary greatly and differ in severity from person to person. The symptoms may not be limited to the digestive system.
Gastrointestinal symptoms
These are the most common symptoms, which can often be mistaken for other conditions.
- Recurrent diarrhoea or constipation
- Variable stool consistency
- Bloating and increased gas production
- Recurrent abdominal pain and cramps
- Large volumes of pale, greasy, foul-smelling stools (steatorrhoea)
- Loss of appetite or nausea
Symptoms outside the digestive system
Gluten sensitivity often causes symptoms that are not apparently related to digestion.
- Skin symptoms: Dermatitis herpetiformis (Duhring’s disease) is an itchy, blistering skin condition that is closely linked to coeliac disease. In addition, patchy hair loss (alopecia areata) and recurrent mouth ulcers may also occur.
- Nervous system symptoms: Gluten-induced ataxia (impaired coordination of movement), peripheral neuropathy (numbness and tingling in the limbs), headaches and migraines may also indicate the problem.
- General symptoms: Chronic fatigue, weakness, iron-deficiency anaemia that does not improve with treatment, osteoporosis and premature bone fractures, as well as mood changes such as irritability or apathy.
In infancy, the most obvious signs may be a halt in growth and weight gain, pallor and abdominal distension. In older children, alongside stunted growth, delayed puberty may also indicate the condition.
An accurate diagnosis of gluten sensitivity
As the symptoms are varied and non-specific, a specialist medical examination is essential for an accurate diagnosis. It is important to emphasise that a gluten-containing diet must not be discontinued until the tests have been completed, as this could lead to a false-negative result. The Endomedix Gastroenterology Centre Its specialists use the very latest diagnostic techniques.
1. Serological tests (blood tests)
This is the first step towards a diagnosis. A simple blood test can detect the antibodies produced by the immune system in response to gluten. The most commonly tested antibodies are:
- Antibody against tissue transglutaminase (anti-tTG): This is the most sensitive test for screening for coeliac disease.
- Endomysium antibody (EMA): It is also very specific to coeliac disease.
- Antibody against deamidated gliadin peptide (DGP): It is particularly useful for young children and in cases of tTG deficiency.
2. Genetic testing (HLA-DQ test)
This test is also carried out using a blood sample and assesses genetic predisposition to coeliac disease (the presence of the HLA-DQ2 and HLA-DQ8 genes). If the genetic test is negative, coeliac disease can be ruled out with almost complete certainty. However, a positive result does not in itself constitute a diagnosis; it merely confirms a predisposition.
3. Histological examination (endoscopy)
If the serological tests are positive, a tissue sample taken during a gastroscopy is required to confirm the diagnosis. Although many people are apprehensive about this procedure, it is important to know that it is now a short, painless procedure that can even be carried out under general anaesthesia. During the examination, a thin, flexible instrument (endoscope) is guided through the oesophagus and stomach to the initial section of the small intestine (duodenum), from where small tissue samples are taken. A pathologist analyses these samples and determines the extent of damage to the intestinal villi.
When should we see a doctor?
If you experience any of the above-mentioned symptoms unrelated to the digestive or intestinal system, particularly if they persist, it is strongly recommended that you consult a gastroenterologist. Do not attempt to self-diagnose or start a gluten-free diet before undergoing a medical examination! The Endomedix Gastroenterology Centre Their experienced specialists help to establish an accurate diagnosis and initiate the appropriate treatment.
Managing coeliac disease: The gluten-free diet
The only effective treatment for coeliac disease and non-coeliac gluten sensitivity is a strict, lifelong gluten-free diet. This involves completely avoiding wheat, rye, barley and products made from these grains.
What is allowed and what isn’t?
- Cereals and foods to avoid: wheat (including spelt and kamut), rye, barley, and anything made from these (e.g. bread, baked goods, pasta, biscuits, beer, breaded foods). Gluten may also be present in hidden forms in processed foods, such as sauces, soup powders and cold cuts, so you should always read product labels carefully.
- Cereals and ingredients suitable for consumption: maize, rice, millet, buckwheat, quinoa, amaranth. The consumption of oats is a matter of debate because, although they are gluten-free in their natural form, they are often contaminated with gluten-containing grains during processing. Only oat products labelled as „gluten-free” are safe. In addition, all vegetables, fruit, meat, fish, dairy products and eggs are naturally gluten-free.
Sticking to the diet can be challenging at first, but there are now plenty of gluten-free products and recipes available. Once you start the diet, your symptoms will usually improve significantly within a few weeks or months, and the lining of your gut will regenerate.
Set out on the path to recovery
The key to living with coeliac disease is an accurate diagnosis and an appropriate diet. Although a gluten-free diet requires a lifelong commitment, the improved well-being and avoidance of health complications make it well worth the effort.
Don’t let uncertainty or a fear of tests hold you back! The Endomedix Gastroenterology Centre We welcome you with a modern, patient-centred approach and gentle diagnostic methods. Take the first step towards a symptom-free life and book an appointment with our experienced specialists, who will guide you through the entire process of diagnosis and treatment.
