disease is an autoimmune disease which is triggered by ingestion of gluten
leading to abnormal autoimmune response causing malabsorption of nutrients and
inflammation of the small intestine. It is estimated that 1% of the total population
in the UK is affected by coeliac disease. The only treatment strategy is a
lifelong gluten free diet.The first
mention about coeliac disease is in the second century, but not much was known
about the disease until 20th century. Coeliac disease is also known
as “gluten sensitive enteropathy”. The
skin condition from which coeliac patients suffer from is known as “dermatitis
herpetiformis” or “Durhing’s disease”. Gluten ataxia is the general
manifestation of coeliac disease. Non-coeliac gluten sensitivity and coeliac
disease were considered same but without HLA similarity because of the similar
symptoms and treatment. But recently it was discovered that gluten sensitivity
is a different condition from coeliac disease (1).
In 1888, Samuel Gee conducted
a clinical study of children and adults in the Great Ormond Street hospital for
Children, the place he worked and presented the study. In the study Gee stated that, “to regulate the
food is the main part of the treatment. The allowance of farinaceous foods must
be small, but if the patient can be cured at all, it must be by means of diet”.
Dr. Willem Karel Dicke discovered the link between coeliac disease and the role
of wheat. He might have observed the clinical improvement of his patients during
the Dutch famine and this later might have contributed to his discovery. His
observation was that when bread was short there was a significant drop in death
rate among children who were diagnosed with coeliac disease from 35% to zero
and it rose after the famine when wheat was again available for the children.
Later in 1954 the British Physician John.W. Paulley discovered villous atrophy
on intestinal samples taken at his surgery which later led to endoscopic biopsy.
Most of the features of coeliac disease were elucidated in the 60’s like the
hereditary character of coeliac disease was discovered in 1965 and dermatitis
herpetiformis in 1966 was recognized as linked to gluten sensitivity