Medical advice

What does endoscopy involve?

An appointment for endoscopy will be made either by your GP or your specialist. You will be given information about how to prepare for the test. On the day, a doctor or nurse will explain exactly what is involved. Endoscopy involves passing a thin, flexible tube through the mouth and down to the small intestine where biopsies are taken. Neither passing the tube nor taking biopsies are painful although it is fair to say the procedure is not particularly comfortable. Your doctor will discuss with you the various ways in which the discomfort can be reduced and you will be able to choose the method that suits you best. The biopsy samples are sent to the laboratory to be examined under a microscope which will show whether or not the villi are abnormal.

And if I do not fancy having endoscopy?

No-one is going to make you undergo any test or investigation. But it is important to appreciate that the only way to be absolutely certain of the diagnosis is by taking a biopsy from your small intestine by endoscopy. The treatment of coeliac disease requires a special diet for life and it's absolutely crucial to be certain about the diagnosis.

How is coeliac disease treated?

 Because the disease is caused by eating gluten, the treatment is to avoid eating any food which contains it. This means following a gluten-free diet for the rest of your life. If you are diagnosed with coeliac disease, the doctor will suggest you should consult a dietician. Sticking to a gluten-free diet requires knowledge about which foods contain gluten and how to maintain a balanced diet without wheat and the other cereals you must avoid. The dietician will provide written information to help you remember.

What exactly is gluten?

Gluten is a protein that is found in flour made from wheat and is also contained in rye and barley. The gluten content of flour is the reason that flour can be formed into dough and then rises during baking. Gluten in flour is contained in many foods but especially bread and pastry.

What foods contain gluten?

Gluten is present in any foods that are made using wheat, rye or barley. Bread, pastry and cakes are all made with flour and contain large amounts of gluten. Breakfast cereals are often made from wheat, rye and barley. Lots of other foods unexpectedly turn out to contain gluten. For example, flour is used as a thickener in many cooking sauces and barley is used in making all beer and lager. Some foods occasionally get contaminated with small amounts of gluten during production or processing. Oats are not believed to be harmful to people with coeliac disease, but some cereals made from oats turn out to contain traces of gluten which make them unsafe to eat. It is worth checking the labels on such products to see if they are gluten-free.