Thanks
Paediatrician
Coeliac disease is a condition affecting the small bowel (mainly the duodenum, but sometimes also the jejunum and ileum). In people with the certain combination of genes, it is triggered by a toxic part of gluten - which is a storage protein in cereals. This toxic part can not be broken down by the enzymes we have in the gut, and if this is able to get into the layers of the bowel, then it can trigger a series of responses.
These response are driven by cells of the immune system. These start to respond to the cereal proteins and then lead to a series of additional responses. These lead onto damage of the bowel, which can then lead to symptoms (in some). In addition, the immune response leads to antibodies - these can be measured in the blood stream
These events only occur in people at risk of Coeliac disease, on the basis of particular genes. These genes can be looked for - but assessment of the genes does not diagnose Coeliac disease. Many more people can have the certain genes, with only a small number developing Coeliac disease.
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