What is coeliac disease? (For Donna)

[Guest guest]

Hello Donna,

You asked about coeliac disease.

It's a condition in which the lining of the small intestine (mucosa)

is damaged by gluten, a protein found in certain cereals such as

wheat, barley and rye. It can cause malabsorption, steatorhhoea and

diarrhoea and lead to other problems such as osteoporosis. Sufferers

obviously are at risk of absorbig insufficient nutrients. Most

patients respond very well to a gluten-free diet and thrive even

when they have lost weight and had bowel problems before diagnosis.

There isn't a significant body of documented evidence of any

connection between coeliac disease and pancreatitis although one or

two suggestions have been made. However, since coeliac disease seems

to be a lot more common than was previously believed, and, in any

case, is much more common than CP, it could just be possible for a

tiny number of people to have both conditions anyway.

On the other hand, it does seem that some patients may have been

misdiagnosed as having coeliac disease when, in fact, their real

problem was CP. As you can see, some of the symptoms are very

similar.

Coeliac disease isn't the only condition which may be diagnosed

where CP is the real culprit. IBS is another.

There are good tests for coeliac disease although inflammation of

the gut and various other factors could just lead to a mistaken

dignosis. This may have happened to me.

In my own case, I was diagnosed as coeliac in 1988. At that time the

ERCP and CT scan were inconclusive in terms of pancreatic damage.

(Of course, I know now that this is very common and that it is often

only in the more advanced stages of CP that actual, visible damage

to the pancreas will occur.)

To-day, my pancreatologist belives that it is highly unlikely that I

am coeliac since CP (which I definitely have, as proved by CT scan

last year....in any case, my mother died of the disease) would

explain all my symptoms throughout my life. I think he is absolutely

right. However, it cannot be 100% certain that I don't have both

conditions. Also, as my gastro pointed out recently, many patients

with digestive problems do better on a gluten-free diet whether or

not they have coeliac disease. I think I might find it hard to

digest gluten also because I have been on a strict gluten-free diet

for so many years in the belief that I had coeliac disease. I have

just begun to reintroduce gluten into my diet and will report

progress! My pancreatologist advised very gradual reintroduction. I

am so used to coping with the gluten-free diet after all these years

that it doesn't cause me any hassle at all but since I now have

other obligatory dietary rules to follow (low fat etc.) and since I

am likely to become diabetic and be unable to eat certain other

foods as I might wish, it would just be a matter of convenience if I

could eliminate the gluten-free element. I think it could well

happen provided I take it slowly.

Hope that amswers your question! It's nothing at all to worry about

for the vast, vast majority of CP patients.

With very good wishes,

Fliss (UK)