COELIAC DISEASE

Coeliac disease originally described in the second century AD by Aretaeus of Cappodocia, was noted to result in diarrhoea and emaciation in both children and adults alike. The word ‘coeliac’ is derived from the Greek word Koiliakos, which was used by Aretaeus and meant ‘suffering in the bowels’. It was not until 1700 years later in 1888 that the next clear clinical account of the condition was given by Samuel Gee (of Gee's Linctus fame) in his classical paper On the Coeliac Affection. He said ‘that if the patient can be cured at all, it must be by means of diet’, and he noted that children on a diet of only mussels improved — although the children complained that the diet was worse than the disease! Although Haas in 1924 advocated a diet of only bananas, it was not until 1953 that Dicke and his colleagues observed the toxicity of wheat. Rye, barley and oats were subsequently shown to exacerbate coeliac disease, although some disagreement remains concerning the toxicity of oats. The modern gluten‐free diet usually excludes wheat, rye, barley and oats and because the condition is a permanent intolerance to gluten, the gluten‐free diet is a diet for life.