Knowledge base - Coeliac disease

Coeliac disease

Celiac disease is an autoimmune disorder in which gluten—found in wheat, barley, and rye—triggers an immune response in the body that damages the lining of the small intestine and the villi. Damage to the villi can impair the absorption of nutrients and cause a variety of symptoms.

Celiac disease is a lifelong condition for which the only treatment is a strict, lifelong gluten-free diet.

Celiac disease is a common condition in Finland >>
The Impact of Celiac Disease on Daily Life >>
Symptoms of celiac disease and heredity >>
How is celiac disease diagnosed? >>

Celiac disease is a common condition in Finland

In Finland, an estimated 2.4% of the population—or about 130,000 people—has celiac disease. The prevalence of celiac disease in Finland is high by international standards, and studies indicate that the prevalence of the disease has increased significantly in recent decades.

In 2000, 2.1% of Finns had celiac disease. The results now show that 2.4% of Finns now have celiac disease.

The impact of coeliac condition on everyday life

Celiac disease is therefore a lifelong condition, and the only treatment is a strict gluten-free diet. This means that all foods and ingredients containing gluten from wheat, barley, and rye must be avoided. Gluten can be found in many surprising products, so following a gluten-free diet requires careful attention and research. It is important for people diagnosed with celiac disease to receive guidance from a registered dietitian to ensure an adequate and varied intake of fiber and nutrients.

On the positive side, the range of gluten-free products has grown considerably in recent years. A wide range of flours, flour blends and flakes for gluten-free baking and cooking are now available. For those who buy ready-made gluten-free products, there is an increasing range of bread, pasta, dough and many other semi-finished products and foodstuffs. Many restaurants and cafés offer gluten-free options.

Even if a person with celiac disease is asymptomatic, strict adherence to a gluten-free diet is essential as the effects can be severe and take years to become apparent.

Celiac disease symptoms and heredity

The symptoms of celiac disease can vary greatly from person to person and can even be asymptomatic. Early diagnosis and treatment are important to prevent the symptoms and complications of celiac disease.

If you suspect you have celiac disease, it is important that you have tests before switching to a gluten-free diet so that any celiac disease can be reliably diagnosed.

What are the symptoms of celiac disease?

The symptoms of celiac disease vary greatly from person to person. Common symptoms include:

Stomach pain, bloating, and gas
Diarrhoea or constipation
Fatigue
Weight Loss
Iron deficiency anaemia
Skin symptoms, such as a rash

It is important to remember that not all people with celiac disease have symptoms. Celiac disease can be asymptomatic, in which case it may go undetected for a long time. If you suspect that you or a loved one may have celiac disease, it is important to see a doctor.

According tothe Finnish Celiac Association, an estimated 2.4% of the population in Finland—or about 130,000 people—have celiac disease. However, only slightly more than 40,000 Finns have been diagnosed with celiac disease, and as many as 90,000 people have the condition without knowing it.

Celiac disease involves a genetic predisposition. If a first-degree relative—such as a parent, sibling, or child—has celiac disease, the prevalence of celiac disease is, on average, about 5–10%. Screening for celiac disease may be considered for first-degree relatives of a person with celiac disease approximately every 10 years, as well as whenever symptoms suggestive of celiac disease appear.

Cutaneous celiac disease and its symptoms

Dermatitis herpetiformis is a skin form of celiac disease. It is a gluten-induced condition that manifests as skin symptoms when gluten-containing grain products are consumed.

According to an article in the Health Library, cutaneous celiac disease occurs in about 10% of adults with celiac disease. The main symptom of celiac disease is an intensely itchy, small-cell rash, most commonly found on the elbows, knees and buttocks.

How is celiac disease diagnosed?

Your doctor can diagnose coeliac condition in several different ways:

Blood Tests: The evaluation for celiac disease usually begins with testing for celiac antibodies in the blood. In typical cases, a diagnosis of celiac disease can be made based solely on antibody tests, without the need for a small intestine biopsy.
Small intestine biopsy: If the diagnosis cannot be confirmed based on antibody tests, a gastroscopy may be performed to take biopsies from the small intestine.

Celiac disease cannot be cured, but it can be managed with a gluten-free diet. A gluten-free diet is a lifelong treatment that prevents the development of celiac disease symptoms and complications. Tests for celiac disease should be performed while following a gluten-containing diet. However, you should not start a gluten-free diet before the tests, as this can make it difficult to reach a reliable diagnosis.

Non-celiac gluten sensitivity

An article in the journal Duodecim 6/2021 discusses gluten sensitivity: Gluten sensitivity is an increasingly common health problem, with people experiencing a range of symptoms that are alleviated by following a gluten-free diet. Unlike celiac disease, there is no clear diagnosis or test for gluten intolerance and its pathogenesis is not fully understood.

Possible causes of symptoms associated with gluten intolerance include increased permeability of the small intestinal mucosa, reactions to other cereal constituents and a lack of tolerance to FODMAP carbohydrates.

Typical symptoms of gluten intolerance:

Abdominal pain and bloating
Diarrhoea or constipation
Fatigue and weakness
Skin symptoms
Headache, brain fog, or other general symptoms

The most important aspect of making a diagnosis is being able to rule out the possibility of celiac disease and grain allergies. When evaluating gluten sensitivity, the goal is to determine whether symptoms improve by avoiding gluten or grain products that trigger symptoms, after celiac disease and grain allergies have been ruled out.

Treatment of gluten sensitivity:

Gluten-free diet
FODMAP diet can be beneficial
Talking to a dietitian is important

When suspecting and treating gluten sensitivity, it is important to be aware of the nutritional challenges of a gluten-free diet. Dietary restrictions and changes should be carefully considered and discussed with a doctor or dietician.