While many people recognise the common digestive issues linked to coeliac disease, fewer are aware of the more subtle symptoms that can easily go unnoticed. As Coeliac Awareness Month approaches in May, Coeliac UK is highlighting the often-overlooked signs of this serious autoimmune condition.
Alice Andrews, health policy lead at Coeliac UK, sheds light on common misconceptions and outlines crucial indicators that warrant discussion with a doctor.
Understanding Coeliac Disease
Coeliac disease is not an allergy or an intolerance, as is often misunderstood. "Coeliac disease is a serious autoimmune condition which is caused by a reaction in the immune system in response to gluten," explains Ms Andrews. "So, when people with coeliac disease eat gluten, it damages the lining of the small intestine where food and nutrients are absorbed. This means when this damage is happening, the body can't properly absorb nutrients from food." She stresses the sensitivity of the condition, adding: "Many people say 'a bread crumb won't hurt', but we know that very small amounts of gluten can be damaging."
Despite affecting one in 100 people in the UK, only 36 per cent are currently diagnosed. This leaves an estimated 500,000 individuals experiencing unexplained symptoms, according to Coeliac UK.
Risk Factors
Certain factors can increase the risk of developing coeliac disease. "If a first-degree family member (parent, sibling, child) has coeliac disease, the chances of having the condition increases to one in 10," Ms Andrews notes. Consequently, if a close family member receives a diagnosis, it is recommended that other family members also get tested. Additionally, individuals with other autoimmune diseases, such as autoimmune thyroid disease, face a higher risk compared to the general population.
Six Subtle Symptoms
Symptoms of coeliac disease are typically persistent, reoccurring, or unexplained. While many are familiar with common gut issues like severe or regular diarrhoea, constipation, unexplained vomiting or nausea, and recurrent stomach pain and bloating, Ms Andrews points out that "coeliac disease is a multi-system disorder and there are a few symptoms that most people are not as aware of."
- Mouth ulcers: "Persistent mouth ulcers are a symptom of coeliac disease that most people aren't aware of," says Ms Andrews.
- Sudden or unexpected weight loss: This can be another indicator that individuals might not associate with the condition.
- Ongoing tiredness: Often overlooked, fatigue can signal underlying issues such as iron deficiency anaemia, or vitamin B12 or folate deficiency anaemia, as highlighted by the NHS.
- Vitamin deficiencies: Malabsorption, where the body struggles to absorb nutrients, frequently leads to deficiencies. "People with coeliac disease are often iron deficient or vitamin B12 deficient," Ms Andrews confirms.
- Numbness and tingling in the hands and feet: "One of the neurological symptoms that people with coeliac disease sometimes experience is peripheral neuropathy, which is a numbness and tingling in your hands and feet," she explains.
- Issues with coordination and balance: "Another neurological sign that many people don't know about is ataxia, which causes issues with coordination," Ms Andrews adds.
When to Seek Medical Advice
If symptoms become severe, reoccurring, or persistent, consulting a GP is crucial. Coeliac UK offers an online "Is it coeliac disease?" symptom checker to help individuals determine if medical advice is necessary.
Diagnosis typically begins with a GP blood test. If positive, or if suspicion remains, a referral to a specialist, often a gastroenterologist, follows. Further investigations, which may include an endoscopy and biopsy, or additional blood tests, then confirm the diagnosis.
Treatment and Complications
Coeliac disease is a lifelong condition, with the only treatment being a strict gluten-free diet. Ms Andrews emphasises that this is not a lifestyle choice but a medical necessity. "They need to follow a strict gluten-free diet so their body and gut can heal and absorb nutrients again," she states, recommending support from a specialist dietitian and resources from Coeliac UK.
Leaving coeliac disease undiagnosed can lead to serious complications, including osteoporosis and anaemia due to nutrient deficiencies. In very rare instances, it can also result in a type of cancer known as small bowel lymphoma.
This Coeliac Awareness Month, Coeliac UK urges the public not to ignore persistent symptoms. To assess your risk of coeliac disease, visit isitcoeliacdisease.org.uk.
