Coeliac disease is a chronic, immune-mediated condition triggered by the ingestion of gluten. If it is not properly diagnosed and monitored, it can lead to long-term complications. Although awareness of coeliac disease has grown in recent years, certain mistakes remain common. These can delay diagnosis or hinder effective management.
Here are some important points to keep in mind, which can help improve adherence to treatment and reduce the risk of long-term complications:
1. Starting a gluten-free diet without a confirmed diagnosis
One of the most common mistakes is removing gluten from your diet before completing the necessary diagnostic tests. Although this may improve digestive or general symptoms, it can interfere with test results and make it more difficult to confirm coeliac disease.
Diagnosis should always be carried out under medical supervision, with appropriate tests carried out while maintaining a normal gluten intake.
2. Thinking coeliac disease only causes digestive symptoms
For a long time, coeliac disease was associated solely with diarrhoea, abdominal pain, or weight loss (the “classic” symptoms). However, ‘non-classic’ forms are generally more common, especially in adults. These can include mild, non-specific digestive symptoms as well as other non-digestive issues such as anaemia, persistent fatigue, bone problems, or mood changes.
Unless these diverse symptoms are recognised, the disease can go unnoticed for years.
3. Believing small amounts of gluten don’t matter
Another frequent mistake is believing that eating small amounts of gluten occasionally is harmless if no immediate symptoms appear. In coeliac disease, even minimal gluten amounts can cause intestinal damage, even if you don’t notice any discomfort.
Managing coeliac disease requires a strict, lifelong gluten-free diet.
4. Underestimating cross-contamination
Cross-contamination is a common cause of persistent symptoms or continued intestinal damage. It can occur in the home kitchen, in restaurants, or during food handling, even when the ingredients themselves are gluten-free.
Keeping utensils separate, practising good hygiene, and being aware of potential risk points can help reduce this problem, especially during the first few months after diagnosis.
5. Using specific “gluten-free” products
Although products labelled as “gluten-free” are safe, they should not make up the entirety of the diet. People with coeliac disease should follow a balanced diet based on naturally gluten-free foods such as fruits, vegetables, legumes, meat, fish, and eggs.
This approach allows for a more varied diet and reduces the risk of nutritional deficiencies.
6. Not Attending medical follow-up after starting the diet
Symptom improvement after adopting a gluten-free diet can create the false impression that further follow-up is unnecessary. However, regular check-ups allow healthcare professionals to monitor adherence, assess intestinal recovery, and identify potential nutritional deficiencies.
Ongoing medical follow-up is essential to ensure proper progress and to detect possible complications.
7. Underestimating the emotional and social impact
Coeliac disease not only requires changes to your diet; it can also impact your social life, family, and work. Failing to recognise these challenges can lead to frustration or feelings of isolation.
Social support and patient education help normalise the disease and promote effective management in both diet and daily life over the long term.
8. Relying on unverified sources
“Fake news” and unregulated content on social media or non-specialist media can cause confusion and information overload. Some recommendations are not evidence-based and may lead to unnecessary dietary restrictions or a false sense of security.
When in doubt, it is best to consult verified healthcare sources and speak with qualified healthcare professionals for guidance.
Avoiding these common mistakes makes it easier to manage coeliac disease and improves quality of life for those affected. An accurate diagnosis, patient education, and support from family and carers are key for safe and sustainable management of the disease.
Frequently asked questions about coeliac disease
Can coeliac disease be cured?
No. Coeliac disease is a chronic condition, but it can be effectively managed with a strict, lifelong gluten-free diet. With good management, people with the condition can lead a normal life.
Forma
Is coeliac disease the same as gluten intolerance?
No. Coeliac disease is an immune-mediated disease that damages the small intestine. Non-coeliac gluten sensitivity (NCGS) does not cause this damage and is managed differently.
Can small amounts of gluten be consumed?
No. Even very small amounts of gluten can cause inflammation and intestinal damage, even if no obvious symptoms appear. For this reason, the diet must be strictly gluten-free.
Is medical follow-up necessary if there are no symptoms?
Yes. Regular check-ups help ensure the diet is being followed correctly, identify any nutritional deficiencies, and prevent complications, even when the patient feels well.
Does coeliac disease only appear in childhood?
No. Coeliac disease can be diagnosed at any age, in both children and adults, including people who don’t have clear symptoms.
INFORMATION DOCUMENTED BY:
Dr Sabela Carballal, Gastroenterology Department at Hospital Clínic Barcelona
