Medical Encyclopaedia › Coeliac disease (short definition)
In brief: Coeliac disease is a lifelong autoimmune disease in which the protein gluten from wheat, rye, barley and related cereals triggers inflammation of the small intestinal mucosa. About one per cent of the population is affected, many of them undiagnosed.
Causes
A prerequisite is a hereditary predisposition with the tissue markers HLA-DQ2 or HLA-DQ8. In those affected, the immune system reacts to gluten and forms antibodies against, among other things, the body’s own enzyme tissue transglutaminase. The inflammation causes the intestinal villi to shrink, so that nutrients are absorbed less well. Coeliac disease is neither an allergy nor an intolerance like lactose intolerance.
Symptoms
Classic symptoms are diarrhoea, bloating, abdominal pain, weight loss and, in children, failure to thrive. Often, however, the symptoms are atypical or absent: tiredness, iron deficiency, bone loss, raised liver values, tooth enamel defects, joint complaints, headaches or fertility problems can be clues. An itchy, blistering skin disease, dermatitis herpetiformis Duhring, is considered coeliac disease of the skin. People with type 1 diabetes, autoimmune thyroid diseases or relatives of those affected have an increased risk.
Diagnosis
First, antibodies against tissue transglutaminase (IgA type) are measured in the blood together with total IgA. In adults, the diagnosis is usually confirmed by gastroscopy with tissue samples from the duodenum; in children, this can be dispensed with under certain conditions. Important: the tests are only meaningful as long as gluten is still being eaten – a gluten-free diet before assessment can distort the results.
Treatment: gluten-free diet
The only treatment is a strict, lifelong gluten-free diet. Even small amounts of gluten can damage the mucosa again; attention must therefore be paid to hidden sources in convenience products, sauces or beer and to contamination during preparation. Naturally gluten-free foods include rice, maize, millet, buckwheat, potatoes, fruit, vegetables, meat, fish and dairy products; specially labelled oats are tolerated by most of those affected. Nutritional counselling helps to get started. On a gluten-free diet, symptoms usually improve within weeks; antibody levels are checked during follow-up.
Gluten-free without coeliac disease?
For people without coeliac disease, wheat allergy or medically diagnosed gluten sensitivity, a gluten-free diet has no proven health benefit. Anyone who notices symptoms after eating cereals should first be examined.
Related terms in the encyclopaedia
Gluten, Gluten-free diet, Transglutaminase antibodies, Intestinal villi, Dermatitis herpetiformis, Wheat allergy, Non-coeliac gluten sensitivity, Malabsorption, Iron deficiency, Autoimmune disease
Further reading on Medizin Aktuell
Sources
- Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS): S2k-Leitlinie „Zöliakie“, AWMF-Register 021-021
- European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN): Leitlinien zur Diagnose der Zöliakie bei Kindern und Jugendlichen, 2020
- Deutsche Zöliakie-Gesellschaft (DZG): Informationen zur glutenfreien Ernährung
Note: This article is for general information and does not replace advice, diagnosis or treatment from a doctor or pharmacist. Last updated: October 2026.