Does your body respond as if you had just swallowed poison every time you eat a slice of pizza or a comforting bowl of pasta? For around 2 million Americans, this is the harsh reality of living with coeliac disease, an autoimmune condition that’s often overlooked, misdiagnosed, or misunderstood.
Coeliac disease is a lifelong immune response triggered by gluten, a protein found in wheat, barley and rye. When someone with coeliac disease consumes gluten, their immune system does not just attack the food; it turns against the small intestine itself. Over time, this repeated immune response damages the lining of the gut, particularly the villi, which are tiny structures that absorb nutrients. Flatten them, and your body starts struggling to take in essentials like iron, calcium, and vitamins.
You cannot see this damage, but your body certainly feels it. Symptoms can range from diarrhoea, bloating, and abdominal pain to fatigue, unexplained weight loss, skin rashes, joint pain, and even infertility. In children, it can show up as stunted growth, irritability or delayed puberty.
One of the more frustrating facts about coeliac disease is how unpredictable it can be. Some people show severe symptoms after eating a tiny crumb of bread, while others feel fine even though the internal damage is mounting. That is part of what makes diagnosis tricky. What adds to the confusion is the rising popularity of gluten-free diets. People might cut out gluten without medical guidance, feel better, and assume they have coeliac. But without testing first, any real diagnosis is impossible, because test results are only accurate if you are still eating gluten regularly.
Unlike a typical allergy or intolerance, coeliac disease is autoimmune in nature. That means the body is not reacting to gluten as an outsider but rather misfiring completely. The only known treatment is to totally avoid gluten for life.
That means reading every label, dodging cross-contamination, and realising gluten lurks in unexpected places like soy sauce, soup mixes, or even some lip balms. Even a small amount can trigger inflammation, symptoms, and long-term complications if left unchecked.
Untreated coeliac disease can lead to iron deficiency anaemia, osteoporosis, neurological disorders, infertility, and in rare cases, a type of small intestine cancer. And it does not always announce itself loudly; many cases are silent, discovered only when a family member gets tested or a doctor digs deeper into another issue.
Still, despite the seriousness of the disease, it is very manageable once diagnosed. The key lies in awareness, early detection, and strict adherence to a gluten-free lifestyle.