Digestive Health

Updated 16 March 2016

Causes of coeliac disease

When your immune system is reacting abnormally to the protein gluten, found in foods such as bread, pasta, cereals and biscuits, chances are good that it is caused by coeliac disease.

0

What causes coeliac disease?

Gluten and a substance related to gluten called gliadin are heavy proteins. They are found particularly in wheat and rye and to a lesser extent, in barley and oats. These proteins are harmful to people who have coeliac disease.

What triggers coeliac disease?

The exact mechanism of this effect is not known, but two alternative theories have been proposed to explain how this harm comes about: the toxic theory and the immune theory.

The toxic theory explained:

According to the toxic theory, people with coeliac disease lack a particular enzyme normally found on the mucous membranes (mucosa) which line the small intestine. The function of this enzyme is to break gluten and gliadin down into smaller particles which are then able to pass through the wall of the intestine into the bloodstream.

So, according to this theory, if a person with coeliac disease eats food containing gluten and gliadin, the lack of this enzyme will lead to an accumulation of gluten and gliadin on the mucous membranes of the small intestine. It is suggested that this accumulated gluten and gliadin has a toxic effect on the mucosa.

The immune theory explained:

Alternatively, the immune theory claims that gluten or the breakdown products of gluten (metabolites) start an immunological reaction in the mucosa of the small intestine, which causes structural abnormalities to develop in the mucosa. Evidence for this is not clear.

Read more:

The symptoms of coeliac disease

 How to diagnose coeliac disease

How coeliac disease can be treated 

Reviewed by Dr Ismail Moola MBCHB (UCT) FCP (SA) Cert Gastro Phys (SA).

Specialist Physician / Gastroenterologist Netcare Sunninghill Hospital and part time Lecturer Department of Internal Medicine, Division of Gastroenterology, Wits University.

Previously reviewed by Dr G Watermeyer MBChBFCP (SA), Cert Gastroenterology (SA), Consultant GIT Clinic Groote Schuur Hospital.

 

Ask the Expert

Digestive Health Expert

Dr. Estelle Wilken is a Senior Specialist in Internal Medicine and Gastroenterology at Tygerberg Hospital. She obtained her MBChB in 1976, her MMed (Int) in 1991 and her gastroenterology registration in 1995.

Still have a question?

Get free advice from our panel of experts

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

* You must accept our condition

Forum Rules