Quick answer

What is coeliac disease?

Coeliac disease is a lifelong condition where eating gluten damages the lining of the gut. Symptoms include bloating, diarrhoea, tiredness and weight loss, but some people have few or no obvious symptoms. Diagnosis involves blood tests and often a gut biopsy — do not start a gluten-free diet before testing.

What is coeliac disease?

Coeliac disease is a serious autoimmune condition where the immune system reacts to gluten — a protein found in wheat, barley and rye. Eating gluten damages the lining of the small intestine, reducing the absorption of nutrients. It affects about one in 100 people in the UK, but many remain undiagnosed because symptoms vary widely.

Coeliac disease is not an allergy or a fad diet choice — it requires lifelong medical management.

Symptoms

Symptoms differ between people and can be gut-related, general, or both:

Gut symptoms:

  • bloating and wind
  • diarrhoea or constipation
  • stomach pain or discomfort
  • nausea

Other symptoms:

  • extreme tiredness
  • unexplained weight loss (or poor growth in children)
  • iron deficiency anaemia
  • mouth ulcers
  • skin rash (dermatitis herpetiformis — an itchy blistering rash linked to coeliac disease)

Some people have no obvious symptoms but still have gut damage — they may be diagnosed after screening because of anaemia or a family history.

Getting diagnosed

Important: Keep eating gluten as usual until tests are complete. Starting a gluten-free diet before blood tests can give falsely negative results and delay diagnosis.

Diagnosis usually involves:

  1. Blood tests — checking for coeliac antibodies
  2. Gut biopsy — if blood tests suggest coeliac disease, a camera test (endoscopy) takes a small sample of the gut lining to confirm damage

A GP can arrange initial tests and refer you to a specialist if needed.

Treatment — a gluten-free diet

The only treatment is a strict lifelong gluten-free diet. This allows the gut to heal and symptoms to improve. Even small amounts of gluten can cause damage without obvious symptoms.

A dietitian helps you:

  • identify safe and unsafe foods
  • plan balanced meals
  • understand labelling — “gluten-free” vs “may contain traces”
  • manage eating out and cross-contamination

Gluten is found in many foods beyond bread and pasta — including some sauces, gravies, sausages, and beer.

Complications of untreated coeliac disease

Without treatment, ongoing gut damage can cause:

  • nutrient deficiencies — especially iron, calcium and B vitamins
  • osteoporosis — from poor calcium absorption
  • fertility problems
  • a small increased risk of certain bowel cancers

These risks reduce significantly once a gluten-free diet is established and the gut heals.

Coeliac disease vs IBS

Coeliac disease and irritable bowel syndrome (IBS) can cause similar symptoms. Testing for coeliac disease is recommended before diagnosing IBS, because the treatments are completely different.

Living with coeliac disease

With a good understanding of the diet, most people live fully active lives. Coeliac UK provides resources, food lists, and restaurant guidance. Annual GP reviews help monitor your health once diagnosed.

When to see a GP

See a GP if you have persistent gut symptoms, unexplained anaemia, or a first-degree relative with coeliac disease. Do not self-diagnose or start a gluten-free diet without testing.

Common questions

What is the difference between coeliac disease and gluten intolerance?
Coeliac disease is an autoimmune condition where gluten triggers gut damage and can cause serious complications if untreated. Non-coeliac gluten sensitivity causes symptoms without the same immune response or gut damage — diagnosis and management differ.
What foods contain gluten?
Wheat, barley and rye — found in bread, pasta, cereals, many sauces, beer, and some processed foods. Oats are often contaminated unless labelled gluten-free. A dietitian helps identify hidden sources.
How is coeliac disease diagnosed?
A GP usually arranges blood tests for coeliac antibodies while you are still eating gluten. If positive, you may be referred for a camera test (endoscopy) with a small sample (biopsy) of the gut lining to confirm diagnosis.
What happens if coeliac disease is not treated?
Ongoing gut damage can lead to malabsorption, iron deficiency anaemia, osteoporosis, fertility problems and a slightly increased risk of certain gut cancers. A gluten-free diet allows the gut to heal.
Are gluten-free foods available on prescription?
Some basic gluten-free staples are available on NHS prescription in parts of the UK — availability varies. Many suitable foods are also sold in supermarkets labelled gluten-free.

Sources