coeliaci

Coeliacs are individuals with coeliac disease, an autoimmune disorder triggered by gluten ingestion in genetically predisposed people. In susceptible individuals, gluten damages the small intestinal mucosa, leading to malabsorption. The disorder affects about 1% of many populations, with higher prevalence among first-degree relatives of affected people.

Symptoms vary widely. In children, common signs include chronic diarrhea, abdominal pain, bloating, and failure to thrive. In adults, symptoms may be non-specific or primarily extraintestinal, such as fatigue, iron-deficiency anemia, osteoporosis, infertility, or dermatitis herpetiformis.

Diagnosis usually starts with serological tests for antibodies such as tissue transglutaminase (tTG-IgA) and total IgA. A small intestinal biopsy showing villous atrophy and increased intraepithelial lymphocytes confirms the diagnosis. Genetic testing for HLA-DQ2 or DQ8 can support ruling out disease but is not diagnostic.

Management consists of a lifelong strict gluten-free diet, avoiding wheat, barley and rye, and minimizing cross-contamination. Nutritional assessment is important to address deficiencies (iron, folate, vitamin D, calcium). Regular follow-up with a clinician or dietitian is recommended to monitor symptoms and growth in children.

Prognosis improves with adherence to a gluten-free diet. Mucosal healing is expected over months to years; untreated disease increases the risk of complications such as osteoporosis, reproductive issues, and certain intestinal cancers, though risk declines with effective treatment.