Coeliac Disease

Coeliac Disease ( CD ) is an immune-mediated intestinal enteropathy that is triggered by exposure to dietary gluten in genetically predisposed individuals ( The Oslo definition for coeliac disease and related terms Jonas F Ludvigsson et al )Dietary gluten is a storage protein found in wheat , rye and barley and is widely used in food processing to give dough the desired baking properties, add flavors and improve texture.

How common ? CD is one of the most common cause of chronic malabsorption the prevalence of CD is thought to be around 1 % American Journal of Gastroenterology in 2013 reported that CD remains under-diagnosed in the US NICE also informs that CD is under-diagnosed particularly when patients are seen in primary care or other non-specialist settings ( NICE 2016 ) The incidence has been increasing steadily in the last 5- yrs - possibly due to better awareness , better diagnostic tools and probable real increases in incidence The female-to-male ratio ranges from 1:3 to 1.5 : 1 CD can affect any age group including the elderly ,usual age of presentation now is 10-40 yrs Current understanding does not support population level screening.

What happens ? ingestion of gluten is...