Coeliac disease is an autoimmune disorder. Exposure to gluten in the diet leads to an abnormal immune response. Several different antibodies may be produced and the subsequent inflammatory response in the small bowel may lead to villous atrophy (shortening of the villi). The reduction in the absorptive area available in the small bowel, leads to many of the complications associated with the chronic malabsorption seen in untreated people with coeliac disease.
Coeliac disease has a worldwide incidence of approximately 0.5 – 1%, however in Northern Europe this incidence rises and the estimates for UK prevalence are between 0.8 – 1.9%. One of the main problems with coeliac disease is detection. Estimates are that 85-90% of people with coeliac are undiagnosed. The multiple presentations of coeliac make it difficult to diagnose and the mean time from symptom onset to diagnosis is 10 years or more.
Once diagnosed, the mainstay of treatment is a gluten free diet and monitoring for relapse and deficiencies.