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Coeliac disease
Coeliacdiseaseisasignificantmedicalconditionthatcanresultinanumberofserious consequencesifnotdiagnosedandtreatedproperly.Itaffectsthesmallintestinethepartofthe digestivesystemresponsibleforabsorbingnutrients.Inapersonwithcoeliacdisease,theliningof thesmallintestineisdamagedbygluten.Glutenisaproteincomponentofwheat,rye,barleyand oats. Malnutrition,osteoporosis,depression,infertilityandasmall(butreal)increasedriskofcertain formsofcancer,suchaslymphomaofthesmallbowel,arejustsomeoftheproblemsthatcan developifcoeliacdiseaseisleftuntreated.Bloodscreeningtestshaveshownthatcoeliacdisease affectsapproximatelyonein100Australians. Damage to the small intestine Thenormalliningofthesmallintestine(alsocalledthesmallbowel)ismadeupofmillionsof finger-likeprojectionscalledvilli.Thefunctionofthecellsonvilliistobreakdownandabsorb nutrientsinfood.Inapersonwithcoeliacdisease,themucosa(lining)ofthesmallintestineis damaged.Thisresultsinaflatteningofthevilli,referredtoasvillousatrophy.Thesurfacearea, whichenablestheabsorptionofnutrientsandminerals,isseriouslyreducedandthiscanleadto nutritionaldeficiencies. Symptoms Thesymptomsofcoeliacdiseasecanrangefromseveretominororatypicalandmayevengo undetected.Somesymptomscanincorrectlybeconfusedwithirritablebowelsyndromeorwheator otherfoodintolerance,whileothersmaybeputdowntostressorgettingolder. Themostcommonsymptomsinadultscaninclude: Anaemia Bloatingandflatulence Diarrhoeaorconstipation Fatigue,weaknessandlethargy Nauseaandvomiting Stomachcramps Weightlossalthoughweightgainispossible.

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Themostcommonsymptomsinchildreninclude: Abdominalpain,bloatingandflatulence Bulky,foul-smellingbowelmotions Chronicanaemia Diarrhoeaorconstipation Nauseaandvomiting Poorweightgainorweightlossinolderchildren Delayedgrowthordelayedpuberty Tiredness Irritability.

Risk factors Peoplearebornwithageneticpredispositiontodevelopcoeliacdisease.Theyinheritaparticular geneticmake-up(HLAtype),withthegenesDQ2andDQ8beingidentifiedasthecoeliacgenes. CoeliacdiseaseaffectsCaucasiansandwestAsians.ItisuncommonintheOrientalAsianandfullbloodAustralianAboriginalpopulation.Environmentalfactorsalsoplayarole.

Coeliacdisease

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Inmanycases,theconditionwillnothavebeendiagnosedinothergenerations;however,afirstdegreerelativeofapersonwithcoeliacdiseasehasabouta10percentchanceofalsohavingthe condition. Diagnosis Coeliacbloodtestscanbeusedforinitialscreening(coeliacserologyandIgA).Iftheresultsare positive,areferraltoagastroenterologistwillbenecessary.Thediagnosismustbeconfirmedby performingagastroscopy,aprocedurethatallowstinysamples(biopsies)tobetakenfromthe smallintestine.Thisprocedureoccurswhilethepersonisundersedationandinvolvesan endoscopebeingpassedthroughthemouthintothesmallintestine. Problems with diagnosis Sincethesymptomsofotherconditionscancloselymimiccoeliacdisease,correctdiagnosiscan onlybemadebyshowingthatthebowelliningisdamaged.Triallingaglutenfreedietdoesnot provideadiagnosisofcoeliacdisease.Subsequentinvestigationswhileonaglutenfreedietwill producenegativeresultsandmaydelaythediagnosisofanotherconditionwithsimilarsymptoms. Thisincludesboththebloodtests(serologicaltesting)andbiopsy(histologicaltesting). A gluten free diet Theonlytreatmentistheavoidanceofallgluten-containingfoods.Thisallowsthebowelliningto recover.Thisstrictattentiontodietmustbelifelong. Obviousfoodsthatcontainglutenincludebread,cakesandpasta.However,thereisalsoawhole rangeofingredientswithinpreparedandcommercialfoodsthatcancomefromaglutensource.It isessentialthatapersonwithcoeliacdiseasebecomeingredientaware.Theguidanceofan accreditedpractisingdietitian,whocangiveassistancewithadvicetosuitindividualneeds,is recommended. Where to get help Yourdoctor Gastroenterologist Anaccreditedpractisingdietitian,contacttheDietitiansAssociationofAustralia TheCoeliacSociety

Things to remember

Coeliacdiseaseisanintolerancetogluteninfood. Evensmallamountsofglutencandamagetheliningofthesmallintestine(bowel),which preventstheproperabsorptionoffoodnutrients. Thereisnocureandalifelongglutenfreedietistheonlywaytomanagethecondition. Damagecanoccurtothesmallintestineevenwhentherearenosymptoms.

This page has been produced in consultation with, and approved by:

CoeliacSocietyofVictoria

Copyight 1999/2009StateofVictoria.ReproducedfromtheBetterHealthChannel(www.betterhealth.vic.gov.au)at nocostwithpermissionoftheVictorianMinisterforHealth.Unauthorisedreproductionandotherusescomprisedinthe copyrightareprohibitedwithoutpermission. ThisBetterHealthChannelfactsheethaspassedthrougharigorousapprovalprocess.Forthelatestupdatesandmore informationvisitwww.betterhealth.vic.gov.au.

Coeliacdisease

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