Why would Amanda be worried that she might have coeliac disease (runs in family history) but she has no symptoms?

Amanda may be worried about having coeliac disease, even in the absence of symptoms, because coeliac disease is known to have a genetic component. If coeliac disease runs in her family history, it means that close relatives, such as parents, siblings, or children, have the condition. The genetic predisposition for coeliac disease is linked to specific genes, particularly HLA-DQ2 and HLA-DQ8.

While not everyone with a genetic predisposition will develop coeliac disease, having a family history increases the risk. Coeliac disease is an autoimmune disorder triggered by the consumption of gluten, a protein found in wheat, barley, and rye. The immune system mistakenly attacks the small intestine in response to gluten ingestion.

It's possible for individuals with a genetic predisposition to have no noticeable symptoms or to have very mild symptoms. Some people with coeliac disease may not experience the classic gastrointestinal symptoms like diarrhea or abdominal pain. Instead, they might have more subtle symptoms or even be asymptomatic, but the autoimmune response can still cause damage to the small intestine over time.

Given the genetic link and the potential for asymptomatic or mild presentations, individuals with a family history of coeliac disease may consider screening or discussing their concerns with a healthcare professional, even if they currently do not exhibit any obvious symptoms.