Coeliac disease: what happens in the body?

Is coeliac disease an autoimmune disease? Can you have coeliac disease without symptoms? How is coeliac disease diagnosed? Find out all about coeliac disease, colloquially referred to as gluten intolerance.

12.03.2024 Imke Schmitz 4 minutes

What is coeliac disease?

Coeliac disease is an autoimmune disease with symptoms including digestive problems after the consumption of products containing gluten. Gluten is a protein and is contained in various different types of grain such as wheat, spelt or rye. The body of anyone with coeliac disease produces antibodies after consuming foods containing gluten. These antibodies are detectable in the blood and damage the intestinal mucosa. This results in the intestine no longer being able to properly absorb the nutrients from food. That includes fats, proteins, carbohydrates, minerals and vitamins. Around 1% of the Swiss population suffers from coeliac disease.

Is coeliac disease the same as gluten intolerance?

Is there a difference between coeliac disease and gluten intolerance? When professionals talk to patients about coeliac disease, they often use the terms interchangeably because “gluten intolerance” is easier to understand. However, there is one important difference between coeliac disease and what is referred to as non-coeliac gluten sensitivity (NCGS). NCGS is not coeliac disease: the mucous membrane of the small intestine is not affected. Nevertheless, sufferers experience coeliac disease-like symptoms when they consume foods containing gluten.

What causes coeliac disease?

The cause of coeliac disease is not fully understood. Medicine assumes that a combination of genetic predisposition and environmental influences can trigger coeliac disease because there are people who carry the antigens for coeliac disease without ever falling ill.

Can coeliac disease go away? Since a cure has yet to be found for the disease, it’s a life-long illness. 

Coeliac disease: what are the symptoms?

The symptoms of coeliac disease can vary greatly. Here are some examples:

  • Digestive problems, like stomach ache, diarrhoea or constipation  
  • Fatigue or exhaustion
  • Iron deficiency and other deficiencies (e.g. vitamin B, vitamin D, anaemia)    
  • Depressive moods 
  • Infertility in women

Note that coeliac disease is also associated with neurological symptoms such as migraines, tiredness, fatigue, peripheral nervous system disorders, eye tremors and unsteadiness of gait. The symptoms of coeliac disease can also affect the skin. Especially in adults, severe rashes appear on various parts of the body. If you notice this symptom or other signs, talk to your doctor.

Coeliac disease: diagnosis by symptoms

Symptoms are crucial to determining the type of coeliac disease at play:

  • Classic coeliac disease: this form of coeliac disease usually appears in the first to third year of life, when parents introduce food containing gluten. Typical symptoms are diarrhoea, fatty stools and fluid retention in the tissue due to protein deficiency. Stunted growth is also possible because the child cannot absorb enough nutrients (malabsorption). Classic coeliac disease affects 10 to 20% of coeliac patients.
  • Symptomatic coeliac disease: malabsorption can result with this type of coeliac disease, too. Most of those affected suffer from non-specific digestive issues. This form of coeliac disease can also cause psychological symptoms such as tiredness, a drop in performance and depression.
  • Sub-clinical coeliac disease: in this case, the symptoms are non-existent or minor. However, the laboratory values are usually abnormal and the mucous membrane of the small intestine may be damaged. Due to the hidden symptoms of coeliac disease, doctors often discover this variant by chance.
  • Potential coeliac disease: those affected exhibit the typical antibodies during a blood test. The mucous membrane of the small intestine does not appear to be damaged at first glance.
  • Refractory coeliac disease: this form is found in less than 1 to 2% of those affected and must be handled carefully. With this type, a gluten-free diet will not lead to an improvement in symptoms for at least 12 months. 

Coeliac disease in children and during pregnancy?

Coeliac disease in babies often occurs in the classic form a few months after weaning. The symptoms of coeliac disease are similar to those experienced in adults. In addition to these coeliac disease symptoms, children may also experience a lack of growth and developmental delays. Worried your child might be suffering from coeliac disease? Consult a paediatrician.

Can coeliac disease be triggered by pregnancy? There is no scientific evidence that pregnancy can trigger coeliac disease. Still, there is a link between coeliac disease and pregnancy: women with undiagnosed coeliac disease are more likely to have complications during pregnancy. Have you been diagnosed with coeliac disease and want to get pregnant? Consult your doctor. They can assess whether the lining of your small intestine has recovered and can absorb sufficient nutrients again.

How do you test for coeliac disease?

Doctors can carry out a coeliac test. There are two ways of diagnosing coeliac disease.

  • Coeliac blood test: certain antibodies are present in increased concentrations in those suffering from coeliac disease. As part of a coeliac disease screening, doctors look for these antibodies in the blood BEFORE changing your diet. A positive antibody test is an indication of coeliac disease but requires another coeliac test.
  • Intestinal biopsy: if the blood test is positive, an intestinal biopsy is usually carried out next. This involves your doctor taking a sample of tissue from your intestine. Testing this tissue sample can confirm or rule out coeliac disease.

Coeliac test: how much does health insurance cover?

Coeliac disease tests are a common service provided by gastroenterologists. Your GP will usually refer you to an appropriate specialist if necessary. Since tests for suspected coeliac disease are medically necessary, your health insurance company will cover the associated costs under basic insurance.

Coeliac disease: what treatments are available?

Diet plays a crucial role in the treatment of coeliac disease. Since there is no cure for coeliac disease, treatment is oriented towards alleviating the symptoms. Those affected follow a life-long gluten-free diet – with good chances of success because, by doing so, they can generally live well with their coeliac disease. What should you not eat if you have coeliac disease? Avoid grains containing gluten, such as wheat, barley and rye, and check the list of ingredients for processed products.

Note that coeliac disease symptoms do not usually include weight gain. When sufferers gain weight after changing their diet, it is almost always due to improved nutrient absorption. This has a beneficial effect on the patient’s general state of health.

Coeliac disease: the right nutrition with healthy recipes

In the Helsana Coach app, you can find delicious recipes to suit your diet, with information on ingredients, preparation and nutritional values. Download the app now.

Important: some patients with coeliac disease swear by the healing power of bioresonance. Caution is advised here, as there’s no cure for this disease. You should avoid methods that hold out the prospect of a cure. It’s better to trust your doctor – they will give you valuable tips on how to deal with coeliac disease.

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