Coeliac Adults
Overview
Immune-mediated damage to the small intestine in response to ingested gluten
Gluten is present in wheat, rye, barley, and oats
Affects 1 in 70 Australians, many are undiagnosed
Symptoms
Persistent or unexplained gastrointestinal symptoms, including diarrhoea, constipation, nausea and vomiting
Recurrent abdominal pain, cramping or bloating and/or distension
Prolonged fatigue (tired all the time)
Unexplained iron deficiency anaemia, folate, or vitamin B12 deficiency
Sudden or unexpected weight loss
Recurrent mouth ulcers, dental enamel defects
In adults, classic gastrointestinal symptoms can be minimal, and they may be of recent onset.
Risk factors
First-degree relatives of patients with coeliac disease – the risk is 10% if the patient has a first-degree relative
Personal or family history of other autoimmune diseases (type 1 diabetes, autoimmune thyroid disease, autoimmune liver disease, Addison's disease, immunoglobulin A (IgA) deficiency)
Syndromes with a high prevalence of coeliac disease (trisomy 21, Williams syndrome, Turner syndrome)
Dermatitis herpetiformis – a chronic, pruritic blistering skin condition with papulovesicular eruptions
Associated conditions
Bone disease:
reduced bone mineral density
low-trauma fragility fractures
premature osteoporosis
Unexplained alopecia
Gynaecological conditions:
unexplained subfertility
recurrent miscarriage
amenorrhoea
Abnormal LFTs (especially elevated transaminases)
Unexplained neurological symptoms, especially:
peripheral neuropathy
ataxia
epilepsy
Depression or mood disorders
Lymphoma
Sarcoidosis