Abstract

Coeliac disease (CD) is an immune mediated disorder of the small intestine in which the ingestion of gluten (found in wheat, barley, rye and possibly in oats) in genetically susceptible individuals (mostly with the human leukocyte antigen DQ2 allele) leads to chronic inflammation and damage of the small intestinal mucosa. CD is a multi-factorial disorder that depends on environmental, immunological and genetic factors.
On the basis of clinical frequency, coeliac disease was previously regarded as a rare disease. In recent years, it has become evident that CD occurs worldwide more frequently than previously thought, showing a prevalence  of up to 2% in Western populations. CD is typically manifested with malabsorption syndrome: diarrhoea, steatorrhoea and loss of weight or failure to thrive. However, the clinical spectrum is highly variable and most cases remain currently undiagnosed because of atypical, silent presentation. CD can be suspected by using serological testing (antiendomysial antibodies or anti-tissue transglutaminase antibodies), but the diagnosis of CD requires documenting of histopathological changes in the small intestinal biopsy. Treatment includes a lifelong gluten-free diet to prevent recurrence of symptoms and potential complications.