Glossary

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Asymptomatic Coeliac disease

Asymptomatic Coeliac disease (also known as ‘Silent Coeliac disease’) is Coeliac disease which is not accompanied by any external symptoms commonly associated with Coeliac disease. Patients with silent coeliac disease also have no symptoms that respond to gluten withdrawal. Patients with this condition often experience a decreased quality of life as gluten still damages their villi in the usual way.

See also

Coeliac Symptoms; Classic Coeliac disease; Coeliac Disease Symptoms In Adults; Coeliac disease; Potential Coeliac disease:; Subclinical Coeliac disease:; Symptomatic Coeliac disease:

At risk family members

Coeliac disease is a genetically linked condition through the Human Leukocyte Antigen (HLA) gene system and tends to run in families. Family members of patients with Coeliac disease who test positive for the coeliac variants of the HLA gene (HLA DQ2 and/or DQ8) are genetically at risk of Coeliac disease.

See also

Blood tests for Coeliac disease (serology); Coeliac Diagnosis

Avenin (Oats)

Oats do not contain gluten, but have a related protein called avenin. Some Coeliac sufferers are also unable to tolerate oats, although most are fine to include gluten-free pure oats in their diet. You should consult with your medical professional prior to introducing oats into your diet.

Biopsy

A Coeliac diagnosis is only confirmed by a visual examination of the lining of the small intestine. This is achieved by taking a small biopsy via an endoscope, and looking at it through a microscope. If coeliac disease is present, the lining of the small intestine should show flattened or damaged villi.

Blood tests for Coeliac disease (serology)

Blood tests for Coeliac disease are used as an initial screening tool to check whether a patient may have Coeliac disease by determining the levels of certain autoantibodies — proteins that react against the body’s own cells or tissues—in their blood. The initial tests will screen for the presence of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA). The results of these tests will determine whether additional testing is necessary. For these tests to be reliable, a patient must be consuming foods that contain wheat, rye, or barley, e.g. gluten-containing grains.

See also

At risk family members; Coeliac Diagnosis

Coeliac disease symptoms in adults

The most common signs for adults are diarrhoea, fatigue and weight loss. Adults may also experience bloating and gas, abdominal pain, nausea, constipation, and vomiting.

See also

Coeliac symptoms; Classic Coeliac disease; Coeliac disease; Dermatitis Herpetiformis; Gluten ataxia

Coeliac symptoms

The most common signs for adults are loose or fatty stools, fatigue and weight loss. Adults may also experience bloating and gas, abdominal pain, nausea, constipation, and vomiting. Stunted growth and anaemia may also be signs of Coeliac disease.

See also

Coeliac disease symptoms in adults; Classic Coeliac disease; Coeliac disease; Dermatitis Herpetiformis; Gluten ataxia

Classic Coeliac disease

Classic Coeliac disease is a common autoimmune condition and presents with signs and symptoms of malabsorption (failure to absorb key nutrients through the intestine). These symptoms include diarrhoea (loose stools), steatorrhoea (fatty stool), weight loss, stunted growth and anaemia.

Coeliac diagnosis

This will be done through the combination of a blood test and a biopsy. Your GP will take a blood sample and test it for antibodies usually present in the bloodstream of people with Coeliac disease. If these are negative, and you continue to suffer symptoms, or if these are positive, a biopsy of your small intestine may be used to confirm the diagnosis.

See also

At risk family members; Blood tests for Coeliac disease (serology); Biopsy; Endoscopy

Coeliac disease

Coeliac disease is an autoimmune condition that causes the body’s immune system to attack its own tissues. Gluten triggers this immune reaction and causes the lining of the small intestine (gut) to become damaged – it may affect other parts of the body too. Coeliac disease is triggered by the ingestion of gluten, the protein component of wheat, rye, barley, and other related cereals. Such exposure results in a variable degree of intestinal damage.

Testing for Coeliac disease involves having blood tests (to help identify people who may have Coeliac disease) as well as a biopsy (to confirm the diagnosis). Oats do not contain gluten, but have a related protein called avenin. Some Coeliac sufferers are also unable to tolerate oats, although most are fine to include gluten-free pure oats in their diet.

 

Dermatitis Herpetiformis

An itchy rash associated with the ingestion of gluten.

Endoscopy

Endoscopy is the test which is used to obtain a biopsy of the small intestine. An endoscope (a thin, flexible tube with a light and camera at one end) is inserted into the patient’s mouth and gently passed down to the small intestine. Before the procedure, the patient is given a local anaesthetic to numb the throat or a sedative to help them relax.

Gliadin-specific antibodies

Anti-gliadin antibodies are produced in response to gliadin, a protein found in wheat, which combines with glutenin to make gluten.

Gluten

Gluten is the common name for the proteins in specific grains that are harmful to persons with Coeliac disease and gluten-related disorders. It is made up of glutenins and gliadins. These proteins are found in all forms of wheat and related grains rye, barley and triticale.

Gluten ataxia

Gluten ataxia is a rare symptom of Coeliac disease. It occurs when the disease affects the nervous system and is often characterized by poor coordination, imbalance, or lack of control of bodily movements.

Gluten free diet

The Coeliac diet involves removing all sources of gluten from your diet. There are sources that might seem obvious. However, there are some foods that might contain hidden sources of gluten. This is why it is important to understand what to look out for on the label. See our useful guide here: http://www.deliciousalchemy.com/gluten-free-guide/

Gluten intolerance

Gluten intolerance is a term which can be used to describe a range of diseases associated with how your body handles gluten. These diseases are Coeliac disease, wheat allergy, or non-Coeliac gluten sensitivity (NCGS).

Gluten sensitivity

Non-Coeliac gluten sensitivity (NCGS) is a condition that occurs in individuals who are unable to tolerate gluten and experience symptoms similar to those associated with Coeliac disease. The normal diagnostic tests for Coeliac disease or food allergies are negative in such individuals, and so this is what is known as a diagnosis of exclusion in that it can only be given once everything else has been ruled out.

Gluten-related disorders

The term is used to describe all conditions resulting from the ingestion of gluten including: gluten ataxia, dermatitis herpetiformis, non-Coeliac gluten sensitivity and Coeliac disease.

Non-classical Coeliac disease

Non-classical Coeliac disease is Coeliac disease which is not accompanied by signs and symptoms of malabsorption (e.g., a patient with constipation and abdominal pain but no malabsorption-related symptoms). Patients who present with only one symptom of the disease (other than loose or fatty stools) usually have non-classical Coeliac disease.

Paediatric Coeliac disease

Paediatric classical Coeliac disease is the name given to classical Coeliac disease in children. The symptoms children suffer from are often characterised by failure to thrive, diarrhoea, muscle wasting, poor appetite and abdominal bloating. Many children with classical Coeliac disease and malabsorption also show signs of emotional distress (‘change of mood’) and lethargy.

Potential Coeliac disease

Potential Coeliac disease relates to people who test positive for Coeliac auto-antibodies in their blood test, but have a normal small intestine biopsy result. These patients are at increased risk of developing Coeliac disease as indicated by positive Coeliac disease serology (blood tests).

Refractory Coeliac disease

Refractory Coeliac disease is a rarer type of Coeliac disease where the symptoms continue, despite switching to a gluten-free diet which contains no wheat, rye or barley.

Subclinical Coeliac disease

Subclinical Coeliac disease is when the disease is present below the threshold of clinical detection.

Symptomatic Coeliac disease

Symptomatic Coeliac disease is characterised by clinically evident gastrointestinal and/or extra-intestinal symptoms attributable to gluten intake. Coeliac disease is highly variable in how it is expressed in a patient, and can vary from having no symptoms at all (asymptomatic Coeliac disease) to showing a wide spectrum of symptoms which may include: ataxia, depression, migraine headaches, short stature (in children), diarrhoea, infertility, constipation, iron-deficiency anaemia, fatigue, joint pain, canker sores in the mouth, or seizures.