Dr Geraint Preest, who practises in Bridgend, Wales, says he supports claims by campaigners from Coeliac UK that most people with the condition do not get diagnosed.

The charity launched a campaign called Gut Feeling this week, calling for half a million undiagnosed people to be identified.

Dr Preest says doctors are advised to check patients for the condition before diagnosing irritable bowel syndrome - but often this does not happen.

The disease is caused by a reaction to gluten and means that sufferers cannot eat foods made with wheat. It is thought to affect about 1% of the population.

Dr Preest became interested when his young daughter, now aged ten, was diagnosed with the condition.

Speaking at the campaign launch in Parliament, he said he conducted a study in his own practice and found that the number of patients diagnosed with the condition was about a fifth of what would be expected.

He said yesterday that doctors should "have a high index of suspicion when patients present with symptoms applicable to coeliac disease.”

He said: "I believe that the opportunity to pick up these patients – as is so often the case – lies with primary care.

"We need to have a high index of suspicion when patients present with symptoms applicable to coeliac disease, especially if there are other diseases present that are known to co-exist with coeliac disease."

His wife Dr Annette Preest said buying food had now proved an "absolute minefield for the unwary.

She writes: "To have the diagnosis was a relief but the reality of the situation soon became apparent.

"We try to keep life as normal as possible and to equip our daughter with the ability to deal with her condition in the future with as minimal impact on her lifestyle and wellbeing as possible.

“And, of course, we remain hopeful that eventually a cure for the condition will be found."

A study by researchers at Manchester University, UK, and Toronto University, Canada, says a condition called allergic bronchopulmonary aspergillosis affects millions of people with asthma world-wide.

The experts say it is a complication of asthma and patients benefit from anti-fungal drugs.

The report, in the journal Medical Mycology, is said to be the first to estimate how many people are affected - some 4,837,000 world-wide. This includes more than a million in Europe and 1.4 million in the Americas.

The researchers say this represents about 2% of 193 million people with asthma worldwide, including seven million in the UK and more than 20 million in India, China and the USA.

Researcher Professor David Denning, from Manchester University, said: “We were surprised by the number of patients with allergic bronchopulmonary aspergillosis, and by the lack of community based studies done.

“Our National Aspergillosis Centre treats hundreds of these patients each year, generally with major improvement, and so a conscious program to seek out ABPA from all asthmatics is required.”

Global burden of allergic bronchopulmonary aspergillosis with asthma and its complication chronic pulmonary aspergillosis in adults. Med Mycol. May 2013;51(4):361-70. doi: 10.3109/13693786.2012.738312

The problem is highlighted by the numbers of children with asthma who need emergency admission to hospital.

These vary by 19 times across England, according to Asthma UK, which launched its campaign on World Asthma Day.

The worst affected areas are Newham in London and Leicester, Birmingham and Blackburn.

The charity says the NHS now has a quality standard for asthma care, launched this year by the National Institute for Health and Clinical Excellence.

It now wants clinical commissioning groups to sign a pledge to implement the standard. It says that all patients should have an asthma action plan - but currently just one in eight patients have these plans.

Its campaigners will gather evidence from patients about the care they receive and whether it meets the standards.

Dr Samantha Walker, of Asthma UK, said: "The Compare Your Care campaign will help us show why it's so vital these are implemented, and will also engage people with asthma in their own care.

"This could help reduce the burden on the NHS and make it easier for GPs and asthma nurses to promote good self-management to their patients."

The spray can only be obtained by GP prescription and combines two powerful treatments.

These are the steroid fluticasone propionate and the anti-histamine azelastine hydrochloride.

Developers say the spray works days faster than the treatments taken on their own.

Trials suggest nearly one in five patients will experience total relief from hay fever by using the combined treatment, known as Dymista.

GP Dr Dermot Ryan said: “It’s all too easy to see hay fever as a nuisance condition, although it remains a challenge for both healthcare professionals and patients to manage effectively.

“Non-adherence to treatment remains a significant issue, with patients unsure whether current first-line treatments are taking effect, based on their relatively slow onset of action and limited relief of symptoms.

"The introduction of new treatments such as Dymista, that can address these issues, is an important development in improving the management of such a common, but difficult to manage condition."

More than two million sufferers are at risk, according to the findings of a survey published today by Asthma UK.

The organisation was launching a "stop asthma deaths" campaign to help cut the toll of 1,140 deaths from the disease each year.

Its survey of more than 50,000 patients found that more than half did not believe they were at risk of a fatal attack.

But, it said, 93% reported having at least one risk factor for a serious attack.

The organisation says patients need to remember to carry inhalers with them and not to ignore worsening symptoms.

David Hiles, of Asthma UK, said: "We must act now to stop more people losing their lives.

"It's particularly vital that healthcare professionals are able to recognise who is at risk, support people to recognise risk factors and help those when they are having an asthma attack. Together, we can change attitudes and save lives."

* Asthma patients have gained from smoking restrictions introduced in England in 2007, researchers report today.

Researchers said the ban has led to 1,900 fewer emergency hospital admissions for asthma patients every year - a reduction of 5%.

The findings are reported in the journal Thorax by Dr Michelle Sims, of Bath University, UK.

* A second survey today finds similar problems among young adults with severe allergies.

The survey found that about a third of young adults did not always carry adrenaline injection pens with them. And more than half reported having spent time in a hospital emergency department after an allergy attack.

Lynn Regent, of the Anaphylaxis Campaign, called for improvements to food labelling and specialist care.

Thorax 16 April 2013 [abstract]

The call comes as the World Allergy Organisation (WAO) launched World Allergy Week yesterday to highlight the need for awareness and understanding of food allergy.

Professor Ruby Pawankar, WAO president, said: “Large areas in the world lack legislation on food labelling, standardised national anaphylaxis action plans for food allergy, or access to adrenaline auto-injectors.

“These circumstances can be improved with the distribution of information and resources for physicians, patients, parents, schools, health ministries and throughout communities and by a call to action to policy makers.”

World Allergy Week has been launched to address the issue of rising numbers of food allergy across world. Globally, 220-250 million people are thought to suffer from food allergy and the number is growing, particularly among children

Foods are among the most common allergens and Professor Motohiro Ebisawa, chair of the WAO Communications Council, said: “Food sensitivity is not a simple disease … It has been increasing in severity and complexity. There are complications with food allergies caused by other allergic diseases such as asthma and atopic eczema. Moreover, food allergy can be fatal.”

Food Allergy Week will examine how to address a variety of safety and quality-of-life issues related to the care of patients with food sensitivity.

“There are problems that need to be addressed in many countries throughout the world,” said Prof Pawanker.

World Allergy Week 2013 comes ahead of the start of the world’s biggest food allergy study, Integrated Approaches to Food Allergen and Allergy Risk Management (iFAAM), within which the UK-based Anaphylaxis Campaign has been a key UK representative.

CEO Lynne Regent said: “We want to spread the word and let people know we’re here to help them, especially as anaphylaxis can be such an isolating and misunderstood condition.”

Multiple sclerosis and the skin disease psoriasis are among conditions that might be triggered by excessive salt consumption.

Researchers in the USA and Germany have found that too much salt can stimulate immune cell components, T cells, linked to the development of these autoimmune diseases.

Reporting in Nature, the researchers say the findings, which come from laboratory research on mice, may help explain the increasing rates of some of these conditions in the last century.

Researcher Professor David Hafler, of Yale University, USA, said: "These are not diseases of bad genes alone or diseases caused by the environment, but diseases of a bad interaction between genes and the environment."

Researcher Professor Jens Titze of the University of Erlangen-Nuremberg, Germany, added: "It would be interesting to find out if patients with psoriasis can alleviate their symptoms by reducing their salt intake."

And fellow researcher Dr Markus Kleinewietfeld added: "The development of autoimmune diseases is a very complex process which depends on many genetic and environmental factors.

"Therefore, only further studies under less extreme conditions can show the extent to which increased salt intake actually contributes to the development of autoimmune diseases."

Sodium Chloride Drives Autoimmune Disease by the Induction of Pathogenic Th17 Cells. Nature 6 March 2013; doi.org/10.1038/nature11868

The warning comes as regulators issued new guidelines for asthma care, calling for patients to get annual "structured" reviews.

The National Institute for Health and Clinical Excellence also warns that adults who develop asthma for the first time should be checked for occupational causes.

NICE says it is issuing some 11 statements as asthma is a high priority area for improvement in England.

According to researchers at Queen Mary College, London, young adults are being driven to reckless behaviour by the high cost of medication, by stigmatisation and by poor acceptance of their illness.

The researchers interviewed 12 adults in their 20s who were high users of the blue emergency inhaler comparing them with nine others who used these inhalers less for the research reported in BMJ Open. High use of the blue inhaler may indicate poor control of the illness.

They found that the blue inhaler users reported regarding the device as something "to hide in a bag" and expressed anger and resentment at their problems.

Professor Chris Griffiths, professor of primary care, said: "Providing free asthma medication, particularly to those on low incomes, could help boost the numbers using preventive medication.

"Better education, particularly at the time of diagnosis, could help people accept and adapt to their illness, while reducing stigmatisation might mean people feel more comfortable about using their inhalers in public."

Emily Humphreys, of Asthma UK, backed the call for free prescriptions and welcomed the NICE quality standards.

She said: "In the meantime it is absolutely crucial that healthcare professionals explain how medicines work, particularly when younger people are diagnosed with asthma, to ensure that they understand how to manage their condition."

The NICE guidance also says that people with difficult asthma should get an assessment from a multidisciplinary specialist service.

Dr Gillian Leng, of NICE, said: "Asthma is a common lung disorder in the UK and can have a significant, negative effect on a person’s quality of life. NICE is pleased to be publishing this new quality standard on asthma, which contains eleven statements that will contribute to improving the quality and experience of care for those with the condition."

BMJ Open 20 February 2013

A study in Stockholm, Sweden, has concluded that 5% of cases of pre-eclampsia may be linked to air pollution.

The research links exposure to high levels of ozone in urban areas in the early weeks of pregnancy to the risk of pre-eclampsia and to the risk of premature birth.

Researchers studied some 121,000 births in the Stockholm region.

The research, published in BMJ Open, found no link between pregnancy complications and vehicle exhaust, measured as the gas nitrogen oxide.

Researcher David Olsson, of Umea University, Umea, Sweden, reports a possible link with asthma. Women with asthma were 10% more likely than others to develop pre-eclampsia.

He writes: "Asthma is an inflammatory condition and ozone may therefore have worsened respiratory symptoms and systemic inflammation, so accounting for the larger increase in the risk of premature birth among the mums with asthma."

Air pollution exposure in early pregnancy and adverse pregnancy outcomes: a register-based cohort study BMJ Open 7 February 2013 doi: 10.1136/bmjopen-2012-001955 [abstract]

Researchers believe the excess numbers of bacteria may trigger immune reactions, causing the disease.

Bacteria begin to grow in the intestines at birth, explain Lotta Nylund from University of Turku, Finland, and colleagues. The types of developing bacteria are affected by many factors, including caesarean versus vaginal delivery, breast milk versus formula, and any antibiotics taken.

The early balance of bacteria "shapes the immune system and potentially affects the development of variety of diseases," say the researchers in the journal BMC Microbiology today (23 January).

Studies have shown links between gut bacteria and allergic eczema. So the team tested 15 infants with eczema and 19 without, at six and 18 months of age.

No differences were seen at six months, but children with eczema had a more diverse set of gut bacteria at 18 months. Specifically, they had a third the amount of bacteria known as Bacteroidetes. They also had bacteria known as Clostridium clusters IV and XIVa, more often seen in adults.

Ms Nylund says: "We found 21 groups of bacteria which changed in this time period. However it is the early change towards adult-type bacteria which seems to be a risk factor for eczema."

The scientists say these differences in children with eczema may perpetuate the condition. They think that the cause may be linked to an antibody called Immunoglobulin A. Abnormal levels are found in people with allergic diseases, and may cause changes in gut bacteria - explaining the results of this study.

Genetic factors may also help explain the differences in gut bacteria between healthy children and those with eczema.

Nylund, L. et al. Microarray analysis reveals marked intestinal microbiota aberrancy in infants having eczema compared to healthy children in at-risk for atopic disease. BMC Microbiology 23 January 2013