Coeliac disease is a condition of malabsorption due to a disorder of the small bowel. It has been shown to be caused by the action of gluten present in cereals.
The exact cause is uncertain but may be due either to some immunological disturbance or to the absence of a specific enzyme which prevents the complete breakdown of gluten so that a toxic substance is formed, damaging the cells forming the wall of the small intestine.
It tends to run in families, but in identical twins the abnormality has been reported only in one of the pair. It occurs in about one in 4000 and may start at any age although it is more common in children.
In childhood, it usually starts soon after gluten is added to the diet. At this stage, the child may produce loose stools, become pot-bellied and may develop anaemia, general wasting, irritability and failure to thrive.
Although the disease has been recognised in Europe for many centuries, it was only in 1950 that Dr W. K. Dicke, of Utrecht, Holland, discovered an effective treatment. He found that the elimination of wheat gluten from the diet of, children with coeliac disease produced a full clinical remission.
Later, the glutens of rye, barley and oats were also regarded as dangerous to these children, but the evidence concerning barley and oats is still controversial.
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