Coeliac disease varies in its clinical expression, and so currently is defined on the basis of small-bowel mucosal pathology - a permanent gluten-sensitive enteropathy. Elimination of gluten-containing foods from the diet is the mainstay of long-term treatment. Gluten is the cause of Coeliac disease, a serious and lifelong auto-immune condition (meaning that the body produces antibodies that attack its own tissues). If there is a relatively low likelihood of coeliac disease in a patient (eg, a small but otherwise healthy child, or a young woman with iron deficiency anaemia), then if serological tests are negative it is reasonable to rule out coeliac disease.

Coeliac disease is a gluten intolerance as opposed to a true food allergy. As such, food intolerances, like Coeliac, usually become worse with age. On the other hand, a food allergy could possibly become less severe or even, though only occasionally, go away as you grow older. It is absolutely essential that a gluten-free diet be maintained permanently. Teenagers, who have been on a gluten-free diet for a number of years, may feel well enough to commence eating normal flour products again. If you have Anti-gliadin antibodies (AGA) which are measured for by ELISA or radio immunoassay blood tests [2]. A standard level should be 10 with an ideal value of 3 to be expected, levels of above 10 indicate Coeliac Disease with many people having in excess of 200.

Substances present in the gluten - prolamine and gliadin- are responsible for the reaction in the body that causes poor intestinal absorption of all nutrients from food intake. The way gluten affects sufferers of Coeliac Disease is not yet fully understood, but it seems to enter the intestinal cells, binding to an intestinal receptor and releasing a substance that damages the defence cells. This renders them unable to absorb food properly, and can lead to diarrhea and malnutrition. These proteins damage the small finger-like projections (villi) that line the small intestine and play a significant role in digestion.

The only effective treatment of Coeliac disease is strict lifelong complete avoidance of Gluten found in cereals such as Wheat, Rye and Barley (many tolerate Oats).However, the only way to confirm a diagnosis is to remove a small piece of tissue from the intestine for analysis in the laboratory.In wheat, rye and barley, can be found a mixture of the proteins, gliadin and glutenin, or gluten which makes up around 80% of the protein contained in wheat. Wheat, of course, provides much of the world's dietary protein. Because of the time span, coeliac disease, diagnosed in adulthood, will usually have resulted in a greater degree of damage to the small intestine than that occurring in childhood.

Coeliac disease is not a condition that can be removed, but the damage caused by gluten can be reversed by adhering to a strict gluten free diet. Any body diagnosed as coeliac should consult an expert dietician for advice. Although there are a list of do's and don't's when it comes to maintaining a diet without gluten, there are a number of foodstuffs which occupy a grey area, and can have different results in different people.

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