Celiac Disease

Coeliac FAQ

Welcome to our Coeliac Disease FAQ. We are going to take a deep dive into this serious autoimmune condition, so strap your seat belts on.

Here at the Intolerance Lab, we test for food intolerances. Coeliac disease is an autoimmune condition, so while it won’t come up on the testing that we do (food intolerances, not autoimmune), we feel that it’s essential to discuss what it is, how it’s different to an intolerance; and also why wheat may not come up on your intolerance test even though you have confirmed coeliac disease.

Let’s go:

What is Coeliac disease?

Coeliac Disease is an autoimmune condition that has a strong hereditary component. When someone with the disease consumes any food product that contains gluten, the immune system is set off, causing the small intestine to become inflamed and as a result the villi there get damaged. The immune system is effectively damaging the small intestine due to the presence of the gluten. Gluten is mostly found in wheat, rye and barley, but is also present in other grains and most processed foods. You can read all about gluten, what it is, where it’s found and how it affects the body in our article titled ‘Gluten FAQ’.

Villi are small fingerlike projections on the surface of the small intestine, and their job is to absorb nutrients into the body. When they get damaged, nutrients can’t be absorbed efficiently, and you are at a high risk of nutrient deficiencies and all of the health complications that come with this.

This damage is thought to occur very slowly over the years. So it can be difficult for people to get a diagnosis. It can also mean that severe symptoms appear to have a ‘sudden’ onset when in actual fact they’ve been developing for a very long time.

Some other names for Coeliac disease include:

  • Coeliac Sprue
  • Non-tropical sprue
  • Coeliac disease
  • Gluten-sensitive enteropathy
We just want you to be aware of these names, as you may come across them in your own research.

What is the prevalence of Coeliac disease?

Coeliac disease is becoming increasingly common, and it’s now estimated that one in every one-hundred people in the USA may suffer from it.
Worldwide, a recent 2018 meta-analysis showed that 1.4% of the world’s population suffers from coeliac disease. This was based on both blood and biopsy results.

What are the risk factors for coeliac disease?

Race, age and gender are not seen as risk factors for coeliac, as people from all walks of life can develop it at any time. Genetics, though, is a considerable risk factor for developing coeliac disease. If you have a close relative (mum, dad or sibling) with Coeliac disease, you also have a one in ten chance of developing it yourself at some point in your lifetime. The most common risk factors include:

  • Family history of coeliac disease – particularly immediate family
  • Having existing type 1 diabetes
  • Having down syndrome
  • Existing thyroid autoimmunity
  • Existing Addisons disease
  • Diagnosed colitis
  • Specific genes are also noted as risk factors. The HLA-DQ2 gene is present in 95% of coeliac suffers, and the other 5% have the HLA-DQ8.
  • The gut microbiome may also play a role. Having an imbalance of good vs harmful bacteria in the gut plays a significant role in the immunity and integrity of the digestive tract, and more recent research is looking into how this may affect people with coeliac disease.
  • Infections in early life. Some studies have also shown that children who have had frequent early childhood infections, and antibiotic use in early life (before two years old), have a higher chance of developing coeliac disease.
  • Gluten exposure in children. In children with a family history of coeliac disease, it has been shown that each gram of gluten consumed daily, increases their risk of later developing the disease by 5%.

What are the symptoms of Coeliac disease?

This is a list of the most common symptoms for adults. It’s not exhaustive, and everyone is different. It can be difficult to be diagnosed with coeliac because of the variance in symptoms. We encourage you to see your GP if you resonate with this list of symptoms, or even if you don’t, but you suspect gluten is still causing your issues.

  • Digestive symptoms can occur, but not always. The most common are constipation, diarrhoea, heartburn, gas and bloating.
  • Dermatitis herpetiform – an itchy rash on the skin that has little red, raised bumps.
  • Anaemia – iron deficiency. If you have unexplained anaemia that keeps coming back, it may be caused by coeliac.
  • Unexplained fatigue
  • Unexplained frequent headaches or migraines
  • Recurrent canker sores/ulcers inside your mouth
  • A diagnosis of osteoporosis or osteopenia.
  • Tingling in your hands and/or feet that is unexplained
  • Pain in your joints, bones and even arthritis
  • Fertility issues, such as recurring miscarriage that is unexplained. Irregular menstruation and other menstrual problems can also be caused by coeliac.
  • Nervous system disorders, such as depression or anxiety
  • Liver issues, such as fatty liver or sclerosis not caused by alcohol

For children, the symptoms tend to be different. They more often will exhibit digestive symptoms, such as bloating, stomach pain and diarrhoea. A failure to thrive, weight loss and iron deficiency also commonly occur in kids with undiagnosed coeliac. The nervous system is also frequently affected, with symptoms such as ADHD, headaches and difficulty concentrating.

Are there health implications for people who have coeliac disease?

Yes, there is some serious health implication for people with Coeliac disease, who leave it untreated, continue to consume gluten or who may be undiagnosed. The following list is some of the more common conditions that can develop from undiagnosed or untreated coeliac disease:

  • Malnutrition from severe nutrient deficiencies. Iron and Vit D deficiency are prevalent in coeliac sufferers, but other deficiencies can also develop.
  • Weakening of bones and increased risk of osteoporosis, osteopenia, and bone fractures – due to the decrease in absorption of Vitamins D, K and Calcium.
  • Serious reproductive issues, such as infertility and recurrent miscarriages. This can be due to inflammation, immune system overactivity, and deficiencies in nutrients that are required to maintain a healthy pregnancy.
  • Intestinal and bowel cancer occurs much more frequently in people with coeliac disease who consume gluten.
  • Developing other food intolerances. Lactose intolerance is quite commonly linked to coeliac suffers; however, once the digestive tract is healed through the consistent removal of gluten, dairy may be able to be tolerated.
  • Depression, anxiety and fatigue commonly occur in coeliac disease patients, especially before they are diagnosed and still have gluten in the diet.
  • Thyroid disorders are largely linked to gluten consumption and often occur in coeliac patients.
    Developing other autoimmune conditions.

How do you test for Coeliac disease?

It is essential to get a proper diagnosis for Coeliac disease, not just a passing comment from your doctor that you may have it. If you resonate with the symptoms or suspect you may have it, please be sure to get properly tested. Here are the testing options:

Blood – this is usually the first test done to assess whether someone has coeliac disease or not. The blood sample is tested for specific autoimmune markers in the blood, which are called antibodies. Most coeliac sufferers will have higher than normal levels of these in their blood sample.

Sometimes blood tests don’t pick up coeliac disease, so if you get a negative result, it is advisable to look into the other testing options as well. 

Biopsy – this is done via endoscopy, and a small sample of your small intestine is taken to confirm a diagnosis. During the endoscopy, a camera is inserted via your mouth into your intestine, and your doctor can view any inflammation and damage that is currently present.  It is not a lengthy procedure, usually taking about 15 minutes to complete. This type of test confirms without a doubt whether you have coeliac disease or not. 

Gene testing – this type of testing is done to assess whether you carry the HLA-DQ2 or the HLA-DQ8 genes. Gene tests can be done via a blood sample, saliva sample or a cheek swab.

Note: To be tested accurately for coeliac disease, you need to have gluten in your diet regularly at the time of testing. This is so that any issues show up. If you have removed gluten for months prior to your test, your intestine may have sufficiently recovered enough to get a negative biopsy result.

Note: Our food intolerance testing does NOT test for coeliac disease. If you know you have coeliac disease, you may also not get a reading for wheat intolerance. The two are very different, and we discuss this in detail below.


Is there a cure for Coeliac disease?

You cannot cure yourself of Coeliac disease, but you can very effectively manage it so that you don’t show any symptoms or suffer any inflammation from it.

Coeliac disease is managed by following a strict gluten-free diet. This is currently the only known way to ‘treat’ the condition and avoid symptom flare-ups.

Going completely gluten-free can seem daunting, but there are many nutritionists that specialize in this today. We highly encourage you to seek help from a professional in this area so that you know exactly what you can eat and avoid any gluten-containing foods and pitfalls right from the start.

For a review of gluten-containing foods, and safe gluten-free foods, along with how to start out on your gluten-free journey, please see our article titled ‘Gluten Intolerance FAQ’.


How is Coeliac disease different to a food intolerance?

Coeliac disease and wheat intolerance can present with similar symptoms, but the two are distinctly different conditions that affect the body in very different ways. They are not one and the same, and it is very possible to have one and not the other.

A food intolerance is a non-life-threatening reaction to components of food, usually protein but not always. The reaction commonly occurs in the digestive system, such as bloating, stomach pain or diarrhoea. It can also occur in other body systems, causing symptoms ranging from headaches to anxiety. In the case of gluten intolerance, when gluten is consumed, the digestive system becomes stressed and reacts in an inflammatory way. This causes the symptoms mentioned above, but it DOES NOT cause the body to attack the villi in the small intestine. When gluten is removed from the diet, the symptoms disappear quickly.

Coeliac disease, on the other hand, is an autoimmune disease, where the immune system overreacts to the presence of gluten, causing severe damage to the small intestine and the villi that reside there. Gluten needs to be removed from the diet for healing to occur, and this healing can take some time.
Another big difference between the two is that Coeliac disease ONLY occurs as a reaction to gluten. In contrast, food intolerances can occur to ANY component of a food and don’t involve the immune system in the same way that autoimmune conditions do.

It is very possible for you to be a diagnosed Coeliac through blood testing and biopsy, but NOT diagnosed with a wheat intolerance on a food intolerance test.A bio-resonance food intolerance test does not test for any autoimmune antibodies, genes, or internal digestive structures; which means that it is impossible for this type of testing to pick up coeliac disease. The same is true of coeliac testing; it cannot detect wheat intolerance. The two are not one and the same thing

Note: If you are a diagnosed coeliac, and wheat does not come up on your intolerance test, it is imperative that you still avoid all forms of gluten in your diet to prevent a flare-up of coeliac symptoms.

In Summary

The topic of today’s article is Coeliac disease, an autoimmune condition with far-reaching consequences. We take you through a full explanation of what the condition is, alongside the most common symptoms and risk factors.

If you suspect that Coeliac disease may be an issue for you, we also cover how you can get properly tested. It’s imperative that gluten remains in your diet for accurate test results, which is something that can be overlooked, resulting in false-negative results.

There is no known cure for Coeliac disease, but it can be very well managed with a strict gluten-free diet. We have an in-depth article titled ‘Gluten FAQ’ that will give you a really good start on a gluten-free lifestyle.

Lastly, we take a look at the difference between Coeliac disease and wheat intolerance. A common question we get is ‘I’m Coeliac, so why doesn’t wheat show up on my intolerance test?’ We’ve covered this tricky topic for you, and we hope that you find this article informative and useful.

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