Overview
Coeliac disease is a serious autoimmune condition in which ingestion of gluten — a protein found in wheat, barley, and rye — leads to damage to the small intestine lining. This prevents proper absorption of nutrients, leading to malnutrition and a range of symptoms beyond the gut. It affects approximately 1 in 100 people worldwide, though many remain undiagnosed. The only effective treatment is a strict lifelong gluten-free diet.
Causes and risk factors
The following factors are associated with the development of Coeliac Disease:
- Immune reaction to gluten in genetically susceptible individuals
- HLA-DQ2 and HLA-DQ8 gene variants required but not sufficient
- Environmental triggers: early gluten introduction, gut infections
- Disrupted gut microbiome
- Other autoimmune conditions increase risk (type 1 diabetes, thyroid disease)
- First-degree relative with coeliac disease increases risk 10-fold
Signs and symptoms
Common signs and symptoms of Coeliac Disease include:
- Diarrhoea — often pale, loose, and offensive-smelling
- Abdominal pain and bloating
- Flatulence
- Constipation in some cases
- Indigestion and nausea
- Weight loss and malnutrition
- Fatigue and weakness
- Anaemia (iron, folate, or B12 deficiency)
- Dermatitis herpetiformis — itchy blistering skin rash
- Mouth ulcers
- Delayed growth in children
- Osteoporosis and joint pain
- Neurological symptoms: headaches, peripheral neuropathy
Diagnosis
Coeliac Disease is typically diagnosed through a combination of medical history, physical examination, and appropriate investigations such as blood tests, imaging, or specialist review, depending on the specific condition and presentation. Your doctor will consider all relevant symptoms and risk factors before making a diagnosis.
Treatment options
Treatment approaches for Coeliac Disease may include:
- Strict lifelong gluten-free diet — only effective treatment
- Dietary supplements to correct deficiencies: iron, folate, B12, calcium, vitamin D
- Regular monitoring and dietitian support
- Bone density monitoring
- Treating associated conditions
- Refractory coeliac disease (rare): corticosteroids or immunosuppressants
Prevention
Cannot prevent coeliac disease. Early diagnosis and strict adherence to gluten-free diet prevent complications.
Complications
If left untreated or poorly managed, Coeliac Disease can lead to complications including:
Osteoporosis, infertility, lymphoma (rare, with poorly controlled disease), neurological complications, and increased risk of other autoimmune conditions.
Sources and references: This article is written in accordance with NHS UK, WHO, and Mayo Clinic clinical guidelines. It is reviewed for accuracy by the SymptomSense content team. ICD-10 code: K90.0. Last reviewed June 2026.