Coeliac and food allergy: is there an association?

I was at a talk many years ago – possibly at Gastro 2009 – where the speaker mentioned in passing that there appeared to be a slightly increased risk of coeliac disease in those with food allergy, and possibly vice versa – of food allergy in those with coeliac disease. The figures she provided seemed so statistically insignificant, and she breezed over it so quickly, that I didn’t recall giving it much further thought at the time – or indeed since.

But this research, published online today, from the University of Trieste in Italy, shows that “sufferers from severe food allergy seem to be at a five-fold increased risk of celiac disease” – in other words, a roughly 5% risk.

Although the numbers assessed were relatively small, if confirmed in future studies, perhaps this should not surprise us. Although coeliac disease is not an allergy, as an autoimmune disease it still involves the immune system, as does food allergy. Could having one form of immune-mediated condition increase your risks of another?

There are many other questions to arise from this. Many coeliacs remain symptomatic after months, even years, on the gluten-free diet. Could an undiagnosed food allergy be responsible for a sub-section of this group’s ongoing ill health? It’s possible, but I imagine more probable in the case of non-IgE food allergy, where symptoms are more likely to be gut-related, rather than severe IgE-mediated food allergy, which is characterised by urticaria, itching, wheezing and other more dramatic oral, circulatory and respiratory symptoms – and which is what the Italian research looked at.

What about other severe allergies? Severe latex allergy, or pollen allergy, or pet allergies; or those with allergic asthma or eczema? Could individuals in these groups have increased risks too?

And what about screening? As the researchers themselves said: “Our findings suggest routine screening for CD should be recommended in patients with severe food allergy.” If indeed the prevalence is 5% in this group, this would roughly tally with the prevalence of coeliac disease in patients with autoimmune thyroid conditions and type 1 diabetes, both groups of which NICE guidelines indicate should be screened for coeliac.

To me, this also highlights once again the importance of obtaining a proper diagnosis for your health issues – and not resorting to self diagnosis and all its potential problems, nor to unverified forms of testing, nor attempting experimental diets, in which we are increasingly encouraged to participate by the likes of personal trainers and unqualified celebrities.

Get it right, and you know exactly what you are fighting; get it right, and you’ll eventually know what associated risks you might have with your condition – as we increasingly learn more about them. This is not a time to be speculating, guessing or listening to the unqualified – no matter how nice and sincere they seem …

Do you have both severe food allergies and coeliac disease? Have you been diagnosed with one, and tested for the other? 

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