May marks Coeliac Awareness Month, a time dedicated to shedding light on coeliac disease - a serious autoimmune condition triggered by gluten, a protein found in wheat, barley and rye. For those affected, consuming even small amounts of gluten can cause damage to the small intestine, leading to a wide range of symptoms and long-term health risks. But what exactly should you look out for, and why is early diagnosis and treatment so important?

Recognising the symptoms

Coeliac disease can be difficult to spot, as symptoms vary widely between individuals. Digestive issues are among the most common signs and may include diarrhea, abdominal pain, bloating, constipation, vomiting and persistent fatigue.

However, not all symptoms affect the digestive system. Non-gut-related signs can include iron deficiency, osteoporosis, a skin rash known as dermatitis herpetiformis, and even unexplained infertility. In children, symptoms may differ and include a slower growth rate, unexplained weight loss, anemia, short stature and pale, foul-smelling stools.

Silent coeliac disease

Interestingly, some people with coeliac disease show no obvious symptoms at all - a form often referred to as "silent" or asymptomatic coeliac disease. Despite the absence of symptoms, damage to the small intestine still occurs, which is why family members of diagnosed individuals are often tested as a precaution. Studies show that even those without symptoms tend to feel healthier after beginning a gluten-free diet.

When symptoms persist: Non-responsive coeliac disease

In some cases, symptoms continue even after adopting a strict gluten-free diet for six to 12 months. This could indicate non-responsive coeliac disease or point to another underlying issue. If symptoms persist, it's important to consult your GP for further evaluation and testing.

The risks of leaving it untreated

Even when symptoms are mild or absent, untreated coeliac disease can lead to serious complications. One common issue is lactose intolerance - damage to the gut can reduce production of lactase, the enzyme needed to digest dairy products.

Nutritional deficiencies are another major concern. A damaged small intestine struggles to absorb essential vitamins and minerals, potentially leading to shortages in iron, calcium, folate, vitamin B12, vitamin D, and more. These deficiencies can, in turn, cause a host of problems, from fatigue and dizziness to bone disorders and anemia.

Iron deficiency anemia and bone health

Iron deficiency anemia is a frequent result of untreated coeliac disease. Since iron is absorbed in the small intestine, a damaged lining can significantly reduce absorption. Symptoms often include tiredness, shortness of breath, headaches and a general lack of energy.

Bone health can also be affected. When the body fails to absorb enough calcium, bones can become weaker over time, leading to osteopenia (low bone density) or osteoporosis (brittle bones). Early diagnosis and strict adherence to a gluten-free diet can help reduce this risk.

Fertility and reproductive health

For some women, undiagnosed coeliac disease can affect fertility, leading to issues such as unexplained infertility or recurrent miscarriages. On a positive note, proper diagnosis and a gluten-free diet can often improve fertility outcomes.

Coeliac disease is more than just an intolerance - it is a lifelong autoimmune condition with serious health implications if left untreated. Recognising the signs, getting tested, and maintaining a strict gluten-free diet are vital steps toward better health and wellbeing.

This Coeliac Awareness Month, take the time to learn more, spread the word, and support those living with coeliac disease.

At Coeliac Association Malta, we're here to help. Whether you are newly diagnosed, seeking guidance or interested in joining our efforts to raise awareness, we welcome your support.

If you'd like to get involved or need assistance, please reach out to us on email: [email protected]; visit: coeliacassociationmalta.org; WhatsApp: 7981 5671 or via Facebook / Instagram: @coeliacassociationmalta

Coeliac Association Malta are full members of Malta Health Network: www.maltahealthnetwork.org