If you suspect you have coeliac disease or are a newly diagnosed coeliac, it can be difficult knowing what to do next. This guide from explains everything you need to know.

So what is coeliac disease?

Coeliac disease is an autoimmune disease which affects 1 in every 100 people in the UK. It is caused by the immune system reacting to gluten, a protein found in wheat, barley and rye. When a person with coeliac disease eats gluten, this causes damage to the lining of the small intestine which can lead to a variety of symptoms and other complications. There are a number of typical symptoms however these can vary significantly from person to person with some people not experiencing any symptoms, therefore we would always recommend you consult your GP with any concerns. Typical symptoms include:

  • Nausea, vomiting, stomach pain, diarrhoea, wind, bloating and constipation (it is often misdiagnosed as Irritable Bowel Syndrome)
  • Tiredness and headaches
  • Anaemia
  • Weight loss
  • Hair loss
  • Mouth ulcers
  • Joint pain
  • In some cases, a severe blistering skin rash called dermatitis herpetiformis
  • Failure to thrive in children

Is coeliac disease the same as gluten sensitivity or wheat allergy?

Coeliac disease is an autoimmune response to gluten. However, some people suffer from gluten sensitivity – this is a newly recognised condition where people who do not have coeliac disease or wheat allergy but nevertheless have symptoms such as abdominal pain, bloating ad fatigue which can be managed by following a gluten free diet.

A wheat allergy or wheat intolerance can again have symptoms that affect the gut and are similar to IBS, or sometimes an allergy can affect the respiratory system – resulting in very different symptoms, such as wheezing, itching and a rash.

It's also worth noting gluten and wheat are different things. Wheat contains several allergens, of which gluten is just one; meanwhile gluten is present in barley, and rye as well as wheat. 'Pure' uncontaminated oats can be tolerated by the majority of people with coeliac disease, but do ensure you check they are gluten free on in the ingredients and allergens section on the pack. However, some people with coeliac disease cannot tolerate these gluten free oats as they contain a protein similar to gluten called avenin. For more information about whether you can include gluten free oats visit Coeliac UK.

Diagnosing coeliac disease

According to Coeliac UK, less than a quarter of people with coeliac disease have been diagnosed in the UK. If you are suffering from any combination of the above symptoms, the first step is to visit your GP to discuss your concerns.

A blood test from your GP will detect the antibodies present in coeliac disease. You need to keep eating gluten for 6 weeks before the blood test, to avoid a false negative result. Gluten needs to be present in your body for the test to be accurate. If the result is positive, a gastroenterologist at your local hospital will then use an endoscope to take a biopsy of the duodenum, which connects the stomach to the small intestine. If there is visible damage to the gut lining, this will confirm the diagnosis.

After being diagnosed, you should be referred to a dietician – if not, be sure to ask your GP for a referral. They will give you great advice on following a gluten free diet and making sure you meet your nutritional needs, as well as which gluten free products are available.

Once you are diagnosed you may be able to get a gluten free prescription to obtain foods designed specifically for your condition. You can chat to your GP about this, or find out more on our About Warburtons Gluten Free page.

Living with coeliac disease

The only treatment for coeliac disease is a strict and lifelong gluten free diet. This may seem daunting at first, but there are many products now suitable for a gluten free diet, and increasingly restaurants and café chains are including gluten free options on their menus. We would recommend you buy the Coeliac UK Food and Drink Directory, an essential guide to which products are safe to eat if you've been diagnosed with coeliac disease.

And what's more, the gluten free food market has expanded a lot in recent years, so it's now much easier for consumers to purchase free from foods – even in a small supermarket or convenience store. Find out where to buy gluten free products in our store locator.

Staying healthy with a coeliac disease diet

When gluten attacks the villi in the small intestine it damages it, so that vitamins, minerals, nutrients and soluble fats cannot be absorbed, leading to deficiencies. Extra vitamins and minerals may therefore be needed due to malabsorption, including:

  • Calcium – found in dairy, soya, and green leafy vegetables
  • Vitamin D – in oily fish, eggs, but also generated by sunlight on your skin
  • Iron – in meat, dark green leafy vegetables, pulses and beans
  • Folate – in liver, broccoli, chickpeas, peas, asparagus
  • Vitamin B12 – found in meat, fish, eggs and dairy
  • Fibre – cauliflower, broccoli, cabbage, celery and beans

Gluten free products can sometimes be lower in fibre than wholegrain products, so it can help to look for higher fibre content in products they eat – the recommended intake is 18g per day. Meanwhile some products are fortified with calcium and iron to ensure you are getting enough.

Even when following a strict gluten free diet, there is a risk of cross contamination if you live with others, so be sure to check out our tips on cross contamination and prevent your symptoms appearing. More of our tips can be found in our Coeliac Disease FAQ.