Coeliac disease is an autoimmune digestive condition that is caused by an adverse reaction to gluten. It affects around 1 in 100 people in the UK, with many being diagnosed in their adult life. However, due to under-reporting and misdiagnosis it is thought that the number of people with Coeliac disease could actually be higher than this. The immune system in those suffering with Coeliac disease mistakenly sees gliadin, a component of gluten, as a threat to the body. The immune system produces antibodies, which cause the surface of the intestine to become inflamed. The intestine surface is usually covered with millions of finger like projections called villi, which help the intestines to digest food more efficiently. In people with Coeliac disease, the villi are damaged which reduces their ability to absorb key nutrients from food. Many people think Coeliac disease is an allergy or food intolerance, however this is not the case, there is currently no cure and the only treatment option for Coeliac disease is a gluten-free diet.
Coeliac disease is actually a wasting disease and causes a malabsorption of nutrients which can lead to weight loss. However, there are other symptoms associated with Coeliac disease such as diarrhoea, constipation, abdominal pain and iron and vitamin deficiencies including vitamin B12, which could all lead to fatigue. Changing to a gluten-free diet can help to control these symptoms and prevent the long-term consequences of the disorder. Excluding gluten is still recommended when symptoms are mild as continuing to eat gluten can lead to further health conditions.
It is currently unknown exactly why people develop Coeliac disease, but there are several factors that are thought to increase the risk, such as having a close relative with Coeliac disease, environmental toxins and already having another autoimmune disease. Coeliac disease is found to be more prevalent in people with autoimmune conditions such as Type 1 diabetes and autoimmune thyroid disease.
Gluten is found in foods that contain the cereals wheat, barley and rye. This includes breakfast cereals, cakes, pasta, most bread, certain sauces (such as soy sauce), soba noodles, couscous and beer. Gluten can also be an ingredient in foods such as chicken broth, malt vinegar, seasonings, spice mixes and condiments. When following a gluten-free diet it may appear extremely restrictive and overwhelming at first, it is possible and extremely important to still eat a healthy, varied and balanced diet. Most supermarkets now stock large selections of gluten free products making following a gluten free diet much easier, it is also important to still read food labels, especially processed foods which can contain gluten in additives (such as modified food starch and malt flavourings).
Gluten is not an essential part of a healthy diet and there are plenty of foods available to choose from for someone following a gluten-free diet. Naturally gluten-free foods include meat, fish, seafood, dairy products, eggs, fruits and vegetables, potatoes, pulses, seeds, nuts, corn, rice, quinoa and oils. To reduce the risk of cross contamination go through your cupboards and get rid of any foods containing gluten and look for replacements. There are plenty of options available online and joining the charity Coeliac UK will provide you with support and information on following a gluten free diet. Many restaurants now offer gluten free (GF) choices on their menus and it is worth checking online to see what choices are available before booking, and also always make the restaurant aware of your condition. If you think you may have Coeliac disease it is essential to continue eating gluten until your doctor makes a diagnosis because if you reduce or eliminate gluten from your diet this may cause an inaccurate result for blood tests and gut biopsy.
There are also a rising number of people who have a negative test for Coeliac disease, but find they are sensitive to gluten and suffer symptoms such as bloating, fatigue, brain fog and stomach problems. There are now tests available to ascertain if you are intolerant to gluten so again it is worth going to your GP as there could also be other reasons for these symptoms. However, if you have no symptoms and are therefore not sensitive to gluten, I would not recommend cutting it out of your diet, because avoidance may cause sensitivity and symptoms to occur in the future should a food containing gluten be eaten. Another reason is because whole grains contain so many nutrients your body needs such as fibre, B vitamins, iron, copper, zinc and magnesium and many gluten free products can be stripped of these with sugar often added to enhance flavour.
Nicola Rose DipCH BSc (Hons) RNutr is a fully Registered Nutritionist and Clinical Hypnotherapist. She worked for a specialist NHS weight management service for many years. If you have any questions on this article please email Nicola at firstname.lastname@example.org