from the Suomen Keliakialiitto ry's website:
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http://www.keliakia.org/view/categories.asp?koodi=eng )
COELIAC DISEASE
Coeliac disease (CD) is a small bowel disorder caused by proteins in wheat, rye and barley. These proteins are called ”gluten”. Because of some genetic factors, the small bowel of a coeliac does not tolerate gluten, upon which an immunological inflammation occurs damaging the villi in the small bowel. Due to the damaged villi, the bowel of a coeliac patient cannot utilise nutrients normally. This may lead to a wide variety of symptoms or signs of malabsorption.
The classical symptoms in CD are diarrhoea and weight loss and failure to thrive in children. However, CD often presents with only mild symptoms of the stomach today , such as pains, loose stools or flatulence. Intolerance of lactose is often present also, because the damaged bowel cannot tolerate the ingested lactose. The nutritional and vitamin deficiencies may cause anaemia, osteoporosis or only tiredness and bad condition in general.
The only treatment in CD is a gluten-free diet, where wheat, rye and barley are strictly excluded. Oats can be included in the adult coeliac patient's diet. When a coeliac patient starts with gluten-free diet, the small bowel villi recover fast, and the function of the bowel and the utilisation of nutrients normalise. This does not mean, however, that CD is cured. To avoid symptoms a coeliac patient needs a life-long, strict gluten-free diet. Thus the condition of the small bowel remains normal.
CD can be screened with different antibody tests in the blood
(gliadin-, reticulin-, transglutaminase- and endomysium antibody tests). For a final diagnosis a small bowel biopsy must be performed to find the villous atrophy typical for CD. Especially the gliadin antibodies are quite unspecific, which means that even a high antibody concentration does not always guarantee CD to exist. Gliadin antibodies may be present also in other diseases.
One should not start a gluten-free diet before the small bowel biopsy investigation has been done. This is because the diet, kept long enough, will spoil the opportunity to perform a correct diagnosis - the villi may have recovered and the typical CD findings can no longer be seen.
The incidence of CD is today about 1:300 in Finland today due to the use of new screening methods and better awareness of the disease.