Coeliac Disease

Question 1

What are the signs and symptoms of Coelic Disease? What are the potential complications?

Answer 1

Signs and symptoms in the GIT
* Diarrhoea
* Fatigue
* Weight loss
* Abdominal pain
* Nausea and vomiting
* Constipation

Systemic symptoms
Anaemia, joint pain and headache, paraesthesia, mouth ulcers, itchy rash

**Complications **: Malnutrition, bone softening, nervous system damage, lactose intolerance,
reproductive issues, cancer

Question 2

What do I need to know about Coeliac Disease?

Answer 2

• To explore aetiological factors that are involved in the development of coeliac disease
• To examine the condition of coeliac disease

Question 3

What likely causes Coelic Disease?

Answer 3

• Genetic predisposition
• Autoimmune response
• Pre-existing Addison’s disease, type 1 diabetes or autoimmune thyroid dysfunction
• Potential triggers - surgery, pregnancy, childbirth, viral infection, severe stress

Remember that the autoimmune patient will be more vulnerable to general infection and
illness

It is important to avoid confusion concerning
intolerance, allergic response and autoimmunity when considering the causes of coeliac disease.
* Coeliac disease is NOT ‘just’ a wheat intolerance
* The precise aetiology is unclear, but is not as simple as an allergic response
* Eating a lot of wheat doesn’t cause coeliac disease
* Coeliac disease is a serious condition which, untreated, has severe multi-system consequences”

Question 4

What is the pathophysiology of Coelic Disease?

Answer 4

Pathophysiology
* Exposure to gluten derived peptide GLIADIN: found in wheat, barley and rye
* Human leukocyte antigen (HLA) presents gliadin to helper T cells
* Helper T cells initiate inflammatory response
* Autoantibodies develop within the immune response
* Lymphocyte infiltration and destruction of the intestinal lining

OATS don’t contain gluten themselves, but may be contaminated by other grains.

Question 5

What are the key diagnostic tests for Coelic Disease?

Answer 5

Diagnosis
* Blood test
* Biopsy

After diagnosis:
* Blood test for anaemia
* Bone scan

Question 6

What are the convential treatments for Coelic Disease? How can herbs help?

Answer 6

Conventional treatment
* Gluten free diet
* Vaccination due to reduced immune function
* Nutritional supplementation

Herbal considerations
Immune support
Demulcent and anti-inflammatory
Gentle depuratives and topical vulneraries

Consider herbal approaches also to the complications, and how to tailor a therapeutic diet where exclusion is needed.