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Understanding Coeliac Disease

What is coeliac disease and is it the same as gluten sensitivity? The symptoms and diagnosis and living with coeliac.   2015-09-21
 

Coeliac disease is a medical disorder that many people wrongly assume and frequently state they suffer from, when they may experience symptoms such as sporadic bloating, periodic abdominal pain/discomfort, or a ‘tummy’ upset following consumption of foods containing gluten.

There is a difference between Wheat Intolerance, also known as Non-Coeliac Gluten Sensitivity and the more serious and chronic Coeliac Disease.

Gluten, what is it?

Wheat, barley and rye all contain gluten a protein compound which provides the essential stretch to dough, thus ensuring that food is both tasty and that cakes are indeed springy and pastry light and flaky.

Gluten intolerance

15-20% of people worldwide experience digestive problems together with weight loss if they eat foods that contain gluten such as bread, cakes, rye and even beer. This collection of ‘gut’ symptoms may be caused either by an allergy to wheat, or by sensitivity or intolerance to gluten, with no chronic long term damage to the lining of the digestive system. With gluten sensitivity you suffer an allergic reaction within seconds or minutes of eating. However, before impulsively removing gluten from your diet, see your GP who may wish to refer you to a specialist unit for specific tests to eliminate the possibility of Coeliac disease. Following this prudent initial route and receiving a non-Coeliac diagnosis, then any unpleasant digestive symptoms will be resolved by simply consuming a gluten free diet. Most foodstuffs are easily obtainable from supermarkets, which often have a section dedicated to a wide variety of gluten free foods.

Coeliac Disease

This serious disorder, which reportedly affects about 1 in every 100 people in the UK, but only 1% of the world’s population, is an autoimmune disease and not a food allergy as gluten intolerance is. This type of disorder develops when the body’s immune system attacks healthy body tissue by mistake.

With Coeliac disease, the immune system reacts to the gluten and causes damage to the surface of the small bowel, thereby disturbing the body’s capacity to absorb nutrients from food. This damage translates into malabsorption of essential minerals and nutrients if foods containing gluten are continually eaten! A higher incidence of Coeliac disease occurs in women (a ratio of approximately 2-3:1), and reportedly can arise at any time during a lifespan. However, typically the prevalence of symptoms happens in either very early childhood or conversely later in life 40-60 years. As this disease is chronic, both its severity and symptoms may develop and symptoms can vary between serious and minor.

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Symptoms of Coeliac disease

According to The University of Chicago Coeliac Disease Centre, there are “hundreds of different symptoms of the disease” including:

  • abdominal symptoms,
  • bone and joint pain,
  • iron deficiency anaemia,
  • vertigo,
  • infertility,
  • mouth sores
  • malnutrition

The list is long so if you suffering from any new unexplained signs and symptoms, always see your doctor. The aim will be to rule out Coeliac disease.

Thus far there is no scheduled screening for the disease and no known cause. Nevertheless it has been reported that the person’s genetic composition together the environment might be major factors.

Diagnosis

To eliminate other digestive disorders there are precise blood tests which are performed to make a definitive diagnosis of Coeliac disease.

Another exact diagnostic test is to take a biopsy of the small intestine, which is removed whilst having an endoscopy performed.

Living with Coeliac

First and foremost is for the sufferer to totally steer clear of gluten for the duration of their lives. Ensuring that they completely adhere to a gluten free diet can be somewhat challenging as some packaging labels attached to so called gluten free foods, may contain traces of this compound, so constant alertness is imperative as any consumption of gluten will cause a resumption of the symptoms of the disease.

Let’s look at some foods that may contain gluten:

  • Keep away from wheat, rye, bran, bulgur, barley and enriched flour and their derivatives.
  • Steer clear of all grain based alcohol and beer.
  • Vigilance must be exercised regarding the purchase of processed foods as many of these contain gluten, such as salad dressings, canned soup, ice cream, instant coffee and more. Read the labels!
  • Hidden gluten is also located in many cosmetic preparations. Read the labels!
  • Many porridge manufactures also make wheat based food products. Consequently your morning oaty breakfast should be avoided.

As Coeliac disease sufferers may become deficient of essential minerals and vitamins, these may be prescribed by a doctor to supplement the gluten free diet.

Coeliac disease and cancer

If left untreated or if the person with Coeliac fails to lead a gluten free lifestyle, he or she may be at risk of certain types of cancer such as bowel cancer, small intestinal cancer and lymphoma.

Research conducted and results reported in the medical journal Gastroenterology, stated that if left untreated Coeliac disease "is associated with intestinal lymphoma and other forms of cancer, especially adenocarcinoma of the small intestine of the pharynx, and of the oesophagus”.

This report also indicated that a complication of this disease are small bowel ulcers, and concluded that if managed inappropriately that “the patient’s quality of life may be seriously undermined”.

Conclusion

This is undoubtedly a serious and chronic illness and certainly not to be likened to a simple gluten sensitivity. However, with such a multiplicity of gluten free food products available, a diet devoid of this compound should not affect any real quality of life, both in terms of enjoying your food and being able to maintain a gluten free diet thereby managing this disease and preventing complications.