Gluten intolerance & coeliac disease


Gluten is a protein that comes from wheat, barley and rye that can be found in lots of foods and drinks such as bread, cakes and beer. While gluten intolerance and coeliac disease are both caused by gluten, they’re separate conditions with different causes.

What is coeliac disease?

Coeliac disease is an autoimmune condition, meaning the body mistakenly attacks its own healthy tissue. The immune system reacts to gluten, damaging the small intestine and making it inflamed.

What are the symptoms of coeliac disease?

Some symptoms are triggered by eating gluten:

  • Stomach pain
  • Diarrhoea
  • Constipation
  • Wind and bloating

You may also have more general symptoms:

  • An itchy rash called dermatitis herpetiformis – most commonly on your elbows, knees or buttocks
  • Fatigue (tiredness)
  • Unexplained weight loss
  • Tingling in your hands or feet
  • Difficulties with co-ordination, speech and balance
  • Children with coeliac disease may grow more slowly than expected, and enter puberty later than expected

Coeliac disease is diagnosed by a blood test, followed by a biopsy (where a small sample of tissue is taken from your intestine). If you think you may have coeliac disease, you should see your Doctor.

How many people have coeliac disease?

You're more likely to develop it if you have:

  • Type 1 diabetes
  • Autoimmune thyroid disease
  • Down syndrome
  • Turner syndrome
  • A parent, brother, sister or child with coeliac disease

If you're in a higher-risk category you should see your Doctor to discuss being tested.

Managing coeliac disease

Coeliac disease is managed by following a gluten free diet.

Untreated, coeliac disease can lead to long-term complications, including weakening of the bones (osteoporosis), certain kinds of anaemia, and an increased risk of bowel cancer. You should follow a gluten-free diet even if your symptoms are mild to reduce your risk of these complications.

What is gluten intolerance?

If your Doctor has confirmed you don't have coeliac disease but you still have symptoms, you may have gluten intolerance.

Having a food intolerance means your body can't properly digest a particular food. This causes symptoms such as bloating, stomach pain, or an itchy skin rash, usually within a few hours of eating.

How is gluten intolerance diagnosed?

There's no specific test for gluten intolerance. Your Doctor may recommend recording what you eat and the symptoms you experience, or cutting out gluten for a specified period of time and seeing if your symptoms improve.

You can then reintroduce gluten-containing foods and see if your symptoms return. You may find you can tolerate a certain amount of gluten before symptoms are triggered.

Eating a restricted diet can make it harder to get the nutrients you need. Your Doctor or pharmacist can help you find a registered dietitian who can support you.

NHS guidance is that you should only restrict your child's diet on the advice of your Doctor or a registered dietician. So if you're worried that your child may have a food intolerance or coeliac disease, you should visit your Doctor as soon as possible.

If you regularly have symptoms such as diarrhoea, constipation, bloating, stomach pains, or rashes, and you're not sure what the cause is, visit your Doctor so they can diagnose the issue.

Next steps

  • If you have symptoms of coeliac disease, or if you're at higher risk of developing it, you should see your Doctor
  • If you have coeliac disease, you should follow a gluten-free diet even if your symptoms are mild
  • If you regularly have symptoms of diarrhoea, constipation, bloating, stomach pains or rashes and you're not sure what the cause is, you should visit your Doctor for a diagnosis