Gluten often gets blamed for a wide range of digestive symptoms, and over the past decade there has been a huge increase in gluten-free products lining supermarket shelves. While some people do feel better avoiding gluten, it’s important to understand that coeliac disease is very different from simply being sensitive to gluten.
What is gluten?
Gluten is a protein naturally found in wheat, barley and rye. It plays an important role in the structure of many foods, particularly baked goods like bread, pasta, crackers and cereals. If you’ve ever tried gluten-free bread and noticed it’s a bit more dense or crumbly, that’s because it doesn’t contain gluten. Gluten helps to give bread its familiar soft and fluffy texture. For most people, gluten can be eaten without any issues. However, for those with coeliac disease, gluten triggers a very different response in the body.
What is coeliac disease?
Coeliac disease is an autoimmune condition. When someone with coeliac disease eats gluten, their immune system mistakenly attacks the lining of the small intestine. Over time, this damages tiny finger-like structures called villi, which are responsible for absorbing nutrients from food. Damaged villi can lead to poor absorption of important nutrients such as iron, calcium, and certain vitamins. Untreated coeliac disease can result in fatigue, nutrient deficiencies, anaemia, bone health issues, and, in children, poor growth. The only treatment is strict, lifelong avoidance of gluten. Even small amounts can trigger symptoms and cause ongoing intestinal damage. Importantly, even if someone with coeliac disease does not experience symptoms, avoiding gluten remains essential to prevent silent intestinal damage and long-term health complications.
What symptoms might occur?
Symptoms of coeliac disease can vary widely and may affect both the digestive system and overall health. Some common symptoms include:
- Bloating and abdominal discomfort
- Chronic diarrhoea or constipation
- Fatigue
- Unexplained iron deficiency
- Nausea
- Weight loss or poor growth in children
Some people may have only mild digestive symptoms, while others may experience more systemic signs such as headaches, low energy or nutrient deficiencies.
When should you get tested?
If you’re experiencing ongoing digestive symptoms or suspect gluten may be causing issues, it’s important not to remove gluten from your diet before being tested. Coeliac disease is typically diagnosed through blood tests and sometimes a biopsy of the small intestine, and these tests require you to be regularly eating gluten beforehand to ensure accurate results.
If symptoms are present, the best first step is to speak with your GP or a dietitian who can guide the appropriate testing and next steps.
It’s important to understand the difference between coeliac disease, gluten sensitivity, and other digestive conditions. Receiving the correct diagnosis ensures you will get the most appropriate treatment and avoid unnecessary or overly restrictive dietary changes.
Written by Maddy Raymond, Accredited Practicing Dietitian (and Coeliac Warrior ?)
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