Five signs you could secretly be coeliac - including back pain

Most of us are aware of coeliac disease, and the fact that it is related to gluten intake. The most common and perhaps well known symptoms include bloating, diarrhoea, stomach pain and tiredness. However, this Coeliac Awareness Month, doctors are issuing warnings around some of the ‘lesser known’ symptoms of the disease, that could lead to a ‘silent coeliac’ diagnosis.

Studies show 75% of Brits with coeliac disease don’t realise they have it, and a third of people who do have it, don’t have any symptoms at all. Dr Alasdair Scott, a gut health specialist at Selph, said: “Coeliac disease is an autoimmune condition, where something triggers in your body to mount an immune response against itself. In the case of coeliac disease, gluten is the trigger. Gluten is a protein found in wheat, barley and rye.

“Gluten itself is harmless and the majority of us can eat it without any issues. However, in about 1-in-100 people, gluten triggers the immune system to attack the lining of the small bowel causing inflammation.

“Coeliac disease can affect you at any age, although the most common age to be diagnosed is between your 30s and 50s. It affects both sexes, but women are more likely to be diagnosed with coeliac disease than men. You’re also more likely to have coeliac disease if someone else in your family has it.

“Around two thirds of people with coeliac disease experience common symptoms. These include diarrhoea, weight loss, stomach pain, bloating and flatulence, fatty floating stools, and tiredness.

“However, although two thirds of people with the disease experience symptoms, this still leaves a huge number of people who do not. This is called ‘silent coeliac disease’.”

What is ‘silent coeliac disease’ and how can you spot it?

Dr Scott explains: “Silent coeliac disease can be tricky to pick up because, by definition, you have none of the common coeliac symptoms. However, there are often more subtle signs that can indicate coeliac disease.”

To help Brits spot the signs of ‘silent coeliac disease’ Dr Scott shares five key signs to look out for:

Anaemia (low iron)

“Coeliac disease affects iron absorption and it’s not uncommon for iron deficiency anaemia to be the only sign of a problem in people with coeliac disease. Signs of anaemia include being very pale in the skin, having a constant, unexplained lack of energy and general feelings of weakness in the body.”

Low bone density

“Coeliac disease affects the absorption of vitamin D and calcium, both of which are crucial for bone health. Indications of a low bone density include back pain, which could be caused by a broken or collapsed bone in the spine, a stooped posture, or a bone that breaks much more easily than expected.”

Tingling and numbness

“The disease can also damage nerve fibres causing abnormalities in sensation or pins and needles. This mainly affects the arms and legs, so if you feel an unusual tingly sensation, it’s best to get this checked out.”

Infertility

“Many women with coeliac disease have a history of infertility. In a study of women being investigated for infertility, 3% were found to have coeliac disease. Although there are many reasons infertility can happen, it’s a good idea to test for coeliac disease if you are struggling to conceive.”

Skin rash

“About 1-in-10 people with coeliac disease get an itchy, bumpy skin rash called dermatitis herpetiformis. These small, clustered papules and vesicles usually erupt on the elbows, knees, buttocks, back or scalp. They can also sometimes appear on the face and groin.”

Dr Scott said: “You might be left wondering if you have coeliac disease or not. After all, those who do have coeliac symptoms mostly struggle with diarrhoea, stomach pain and bloating.

“That’s because irritable bowel syndrome (IBS) causes exactly the same symptoms. In fact, 36% of people with coeliac disease have been misdiagnosed with IBS before their coeliac diagnosis."

“The bottom line is that if you want to know if you have coeliac disease, you need to take a coeliac disease blood test and you need to take one sooner rather than later.” Dr Scott adds.

“If this blood test is negative and you’ve had gluten in your diet in the weeks before testing, you can be confident that you don’t have coeliac disease. On the other hand, if your antibody level is raised, it’s very likely that you have coeliac disease.

“If you do have coeliac disease, the main treatment is to go on a gluten-free diet. This means cutting out any foods containing wheat, barley or rye. This includes bread, pasta, cakes and even beer. The good news is that following a gluten-free diet will allow your gut to heal completely and you should have no symptoms or complications from coeliac disease.”