Coeliac disease living in teenagers

Overview

Coeliac disease is an autoimmune condition where the body's immune system attacks the lining of the small intestine when gluten is eaten. Gluten is a protein found in wheat, barley, and rye.

Coeliac disease affects about 1 in 100 people worldwide, but many do not know they have it.

It can affect anyone, but it is more common in people with a family history of coeliac disease or with other autoimmune conditions like type 1 diabetes.

Symptoms

Common symptoms

• Bloating and gas
• Diarrhoea or constipation
• Stomach pain
• Feeling very tired
• Unexplained weight loss

Symptoms in children

• Delayed puberty
• Poor growth or being underweight
• Anaemia (low iron levels)
• Fatigue and irritability
• Mood changes

Symptoms in older adults

• Anaemia that does not get better with iron
• Bone thinning (osteoporosis)
• Vitamin deficiencies
• Itchy skin rash (dermatitis herpetiformis)
• Mouth ulcers

Causes

Main causes

• Coeliac disease is caused by a combination of genes and an environmental trigger. Eating gluten triggers the immune reaction that damages the small intestine.

Risk factors

• Having a parent, sibling, or child with coeliac disease
• Having another autoimmune condition like type 1 diabetes, thyroid disease, or rheumatoid arthritis
• Carrying certain genetic markers (HLA-DQ2 or HLA-DQ8)

When to see a doctor

See a doctor urgently if:

• If you have sudden severe abdominal pain or vomiting that does not stop.

Book a routine appointment if:

• If you have ongoing digestive problems, tiredness, or other symptoms that could be coeliac disease, see your GP for a blood test.

Diagnosis

Diagnosis starts with a blood test to check for certain antibodies. If the blood test is positive, you will have a small procedure called an endoscopy to take a sample (biopsy) from your small intestine to confirm the damage.

Tests that may be done

• Blood test for tissue transglutaminase antibodies (tTG-IgA)
• Endoscopy with biopsy of the small intestine

What to expect at your appointment

You will need to eat gluten (about one slice of bread per day) for at least 6 weeks before the blood test. The endoscopy is done under sedation, takes about 15 minutes, and you can usually go home the same day.

Treatment

The only treatment is a strict, lifelong gluten-free diet. This means avoiding all foods and drinks that contain wheat, barley, or rye.

Self-care at home

• Learn to read food labels and look for gluten-free certification.
• Avoid cross-contamination – use a separate toaster, chopping board, and utensils for gluten-free foods.
• Plan meals and snacks ahead, especially when eating out or travelling.
• Cook from scratch using naturally gluten-free foods like fruits, vegetables, meat, fish, rice, and potatoes.

Medical treatments

Your doctor may prescribe vitamin and mineral supplements if tests show you are deficient. There are no medications to treat coeliac disease itself. Always talk to your healthcare team before taking any supplements.

When is surgery considered?

Surgery is not needed for coeliac disease.

Living with this condition

For teenagers, managing coeliac disease means planning meals, checking ingredients when eating out, and being open with friends about your dietary needs. It can feel isolating at times, but support is available.

Lifestyle tips

• Carry gluten-free snacks with you.
• Inform your school, college, or workplace about your dietary needs.
• Join a support group (like Coeliac UK) to connect with others who understand.
• Learn to cook simple gluten-free meals.

Diet and exercise

A gluten-free diet can be healthy and balanced. Focus on getting enough fibre, iron, calcium, and B vitamins. Exercise is important for overall health – coeliac disease does not limit physical activity, so stay active.

Mental health and emotional wellbeing

Living with a chronic condition can cause stress, anxiety, or feeling different. It is normal. Talk to a trusted adult, school counsellor, or your GP. If you feel overwhelmed, seek support – your mental health matters.

Prevention

Coeliac disease cannot be prevented because it is genetic. However, a gluten-free diet prevents complications and helps you feel well.

Screening programmes

If you have a first-degree relative (parent, sibling, child) with coeliac disease, you should be tested even if you have no symptoms.

Complications

If left untreated

• Anaemia (low iron and other nutrients)
• Osteoporosis (weak, brittle bones)
• Infertility or problems during pregnancy
• Increased risk of intestinal lymphoma (a rare cancer)
• Dental enamel defects

Long-term outlook

With a strict gluten-free diet, most people with coeliac disease feel much better and have a normal life expectancy. It takes time to adjust, but many teenagers manage well and live full, healthy lives.

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