Coeliac disease (Part 2)
Last week I discussed causes of Coeliac Disease (CD)
For some, symptoms may only be mild and perhaps occasional, whilst for others, they may be persistent and severe. With CD, because the body is unable to absorb nutrients fully (malabsorption), the most common symptom of CD is Diarrhoea, often severe and foul smelling. This symptom is often misdiagnosed or presumed by the sufferer to be irritable bowel syndrome (IBS).
Other common symptoms may include: -
- Excessive wind/ flatulence
- Persistent or unexplained gastrointestinal symptoms, such as nausea and vomiting
- Recurring stomach pain, cramping or bloating
- Extreme tiredness
- Iron, vitamin B12 or folic acid deficiency
- Sudden or unexpected weight loss (but not in all cases)
- Mouth ulcers
- Itchy skin rash (dermatitis herpetiformis, see below))
- Neurological (nerve) problems such as ataxia (loss of coordination, poor balance) and peripheral neuropathy (numbness and tingling in the hands and feet)
Whilst not a direct symptom of CD, but also gluten related, up to 20% of people with CD may also develop an itchy skin rash – Dermatitis herpetiformis. The rash presents as red raised patches with blisters that burst when scratched.
Most commonly affecting the elbows, shoulders, knees, buttocks, and face, it can however, appear anywhere on the body. It can appear at any age, but is most common in those in their 50’s and 60’s.
For most, it should clear up once a gluten free regimen is established. For those where the rash is more belligerent, the drug Dapsone can be prescribed and has proved successful in helping to clear the condition.
With many of the symptoms of CD being common to other conditions, people may not necessarily think of CD as the cause. People may go for considerable periods of time treating conditions such as constipation, indigestion, bloating etc as stand-alone issues; perhaps using readily available over the counter medications to treat a single condition.
Doctors can do a blood test to test for antibodies usually found in blood from those with CD. If CD antibodies are present in the blood sample, the GP will refer the patient to a consultant gastroenterologist for a biopsy of the intestines. In some cases, where no antibodies are present in the blood sample, but symptoms continue, the GP might still refer for biopsy. The biopsy will be carried out at hospital using an endoscope to retrieve small samples of the lining of the small intestine. The samples will be examined for indications of CD.
To be continued… next week I discuss treatment of coeliac disease.
For comprehensive and free health advice and information call in to Whelehans Pharmacies, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore)