Coeliac Disease
Informed by recognized medical guidance
Overview
Coeliac disease is a condition where your immune system reacts to gluten, a protein found in wheat, barley, and rye. This reaction damages the lining of your small intestine and stops your body from absorbing nutrients properly.
Key facts
- It is an autoimmune condition, not an allergy or food intolerance.
- The only treatment is a strict, lifelong gluten-free diet.
- If left untreated, it can lead to complications like osteoporosis and malnutrition.
Coeliac disease affects about 1 in 100 people worldwide, but many remain undiagnosed.
It can affect anyone at any age, but it is more common in people with a family history of the condition or certain other autoimmune diseases.
Symptoms
- Severe abdominal pain that does not go away
- Signs of dehydration: dizziness, fainting, fast heartbeat
- Severe vomiting or diarrhoea that prevents keeping fluids down
- ⚠Persistent diarrhoea lasting more than a few days
- ⚠Unexplained weight loss
- ⚠Severe fatigue that affects daily life
- ⚠Signs of anaemia: pale skin, shortness of breath, chest pain
Common symptoms
- Diarrhoea
- Bloating and gas
- Fatigue
- Anaemia (low iron)
- Unexplained weight loss
- Abdominal pain
Symptoms in children
- Failure to thrive (poor growth)
- Delayed growth
- Irritability
- Chronic diarrhoea
- Vomiting
Symptoms in older adults
- Fatigue
- Anaemia
- Bone or joint pain
- Skin rash (dermatitis herpetiformis)
- Mild digestive symptoms
Causes
Main causes
- Coeliac disease is an autoimmune condition triggered by eating gluten in people who have a genetic predisposition.
Risk factors
- Family history of coeliac disease (first-degree relative)
- Type 1 diabetes
- Down syndrome
- Autoimmune thyroid disease
- Genetic markers HLA-DQ2 and HLA-DQ8
When to see a doctor
See a doctor urgently if:
- If you have severe abdominal pain, bloody stools, or signs of dehydration.
Book a routine appointment if:
- If you have ongoing digestive problems like diarrhoea, bloating, or abdominal pain.
- If you have unexplained weight loss or persistent fatigue.
- If a close family member has been diagnosed with coeliac disease.
Diagnosis
Diagnosis involves a blood test to check for specific antibodies, followed by a biopsy of the small intestine to confirm damage. It is important to continue eating gluten before testing, as stopping can affect results.
Tests that may be done
- Blood test for tissue transglutaminase antibodies (tTG-IgA)
- If positive, an upper endoscopy with biopsy of the small intestine
What to expect at your appointment
The blood test is simple, like a routine blood draw. The endoscopy is done under sedation and takes about 15–20 minutes. You can usually go home the same day.
Treatment
The main treatment is a strict, lifelong gluten-free diet. This allows the intestine to heal and symptoms to improve over time. A dietitian can help you plan and maintain the diet.
Self-care at home
- Eat only foods that are naturally gluten-free: fruits, vegetables, meat, fish, eggs, dairy, rice, quinoa, and potatoes.
- Avoid all foods containing wheat, barley, and rye.
- Check food labels carefully – gluten can be hidden in sauces, soups, and processed foods.
- Prevent cross-contamination at home by using separate toasters, cutting boards, and utensils.
- Inform restaurants of your needs when eating out.
Medical treatments
Your doctor may recommend vitamin and mineral supplements to correct deficiencies, such as iron, folate, calcium, and vitamin D. In some cases, medications can help manage associated conditions. A dietitian can provide personalised advice. No specific drugs are approved to treat coeliac disease itself.
When is surgery considered?
Surgery is not a treatment for coeliac disease. It may be needed in rare cases if serious complications, such as intestinal lymphoma, occur.
Living with this condition
Living with coeliac disease requires careful attention to diet, but many people lead healthy, active lives. It is important to read food labels and communicate your needs when eating out. Over time, following the diet becomes second nature.
Lifestyle tips
- Build a daily routine around naturally gluten-free whole foods.
- Find gluten-free alternatives for bread, pasta, and other staples.
- Plan ahead when travelling or attending social events.
- Join a support group for tips and encouragement.
Diet and exercise
A balanced gluten-free diet combined with regular exercise helps maintain overall health and bone strength. Pay special attention to calcium and vitamin D, as these are important for bone health. A dietitian can help ensure you are getting all necessary nutrients.
Mental health and emotional wellbeing
Living with a chronic condition can be stressful. Some people feel anxious or isolated about food choices. It is important to acknowledge these feelings and seek support from a doctor, counsellor, or support group if needed. You are not alone.
Prevention
Coeliac disease cannot be prevented if you have the genetic risk. Some research suggests that how and when gluten is introduced in infancy may affect risk, but this is not proven. If you have a family history, talk to your doctor about monitoring.
Screening programmes
Screening is not recommended for the general population, but may be advised for close relatives of someone with coeliac disease. Discuss this with your doctor.
Complications
If left untreated
- Malnutrition due to poor absorption of nutrients
- Osteoporosis (weak, brittle bones)
- Infertility or miscarriage
- Lactose intolerance
- Rarely, certain cancers (like intestinal lymphoma)
Long-term outlook
With a strict gluten-free diet, most people with coeliac disease can live healthy, normal lives. The intestine heals over time, and symptoms usually improve within weeks to months. Staying on top of your diet is key to long-term health.
Find support
International organisations
Local organisations
- Coeliac UK ↗ · United Kingdom
- Celiac Disease Foundation ↗ · United States
- Canadian Celiac Association ↗ · Canada
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Related conditions
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 16, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.