Coeliac Disease: The Gluten Free Way

Coeliac disease is a digestive disease caused by the body’s inability to digest gluten. It is also a genetic disease that can run in families, being passed on from parent to child. Sometimes coeliac disease is triggered, or becomes active for the first time, after surgery, pregnancy, childbirth, viral infection, or severe emotional stress. A sufferer of coeliac disease may suffer from any or all of the following complaints including; bowel symptoms, weight loss or failure to gain weight, and lack of certain vitamins and minerals with consequential problems such as anaemia and osteoporosis.

Coeliac disease damages the small intestine and interferes with absorption of nutrients from food. People who have coeliac disease cannot tolerate a protein called gluten, which is found in wheat, rye, and barley, oats or any food products that contain those ingredients. When people with coeliac disease eat foods containing gluten, their immune system responds by damaging the small intestine. Villi, which form the lining for the small intestine, are lost, and as nutrients from food are absorbed into the bloodstream through these villi, a person can become malnourished, regardless of the quality or quantity of food eaten. It seems that the genes in some people predispose them to coeliac disease. The result is that sub-sections of the proteins (peptides) found in wheat, in gluten and gliadin, become toxic to the lining of the gut (the mucosa).

Symptoms
Many people suffer from headaches, mouth ulcers, weight gain or weight loss, poor immunity to disease, and skin problems such as dermatitis and eczema. But the common and well known Gluten intolerance symptoms are gastro-intestinal (diarrhoea, flatulence, bloating etc.). The affects that coeliac disease have on the gastro-intestinal functions of a person with the condition means that their bodies absorb less nutrients from the bowel, and thus weight loss ensues and child sufferers may not develop at the normal rate of their peers. Children with coeliac disease may eat a lot, but not put on any weight or lose weight. Sufferers sometimes have a swollen or bloated belly.

People with coeliac disease may also develop problems associated with absorbing iron and vitamins less well causing anaemia, which leads to a feeling of general tiredness and sometimes shortness of breath or fluid retention.

Coeliac disease may cause problems in the bones by reducing the absorption of calcium and vitamin D from food. This may lead to the development of osteoporosis or osteomalacia.

There is a skin condition with a red blistery rash, known as Dermatitis Herpetiformis, which is associated with gluten sensitivity. This is also treated by adopting a gluten free diet, although medication is also sometimes used in addition.

The symptoms of gluten intolerance may overlap with many other ailments and as a result this condition is often missed or misdiagnosed through blood testing. The most efficient and way to identify whether or not you may be gluten intolerant, or suffer from coeliac disease is by undertaking an elimination diet. By abstaining from eating any foods that contain gluten for a period of time you can see for yourself whether any of the symptoms that you had before disappear.

As well as the symptoms of the disease itself, people with coeliac disease have a slightly higher risk of certain bowel tumours. It appears that a gluten free diet reduces these risks. It is thus all the more important that people with coeliac disease adhere to their diet and have regular health checks.

Diagnosis
If you think that your body is not in top health or have symptoms that alert you to the fact that you may have an allergy of some kind it is always best to see a health professional for their expert opinion. A simple blood test is the quickest way to check for anaemia and also a special blood test (anti gliadin antibodies and/or endomysial antibodies) may be reccommended if you suspect that you are gluten intolerant or may have coeliac disease.

If the blood test is not quite conclusive, your health professional may suggest adding extra bread to your diet for six weeks and repeat the blood test. This is likely to make the test positive in someone who is sensitive to gluten.

A simple way of testing for yourself whether or not you have an allergy or intolerance to gluten is to undertake the Elimination Diet. This diet is simply a means of finding out whether or not you have a food allergy or intolerance; it is not for the purpose of losing weight. The Elimination Diet is done by adhering to a restrictive diet for a short period of time eating only very basic but balanced diet of unprocessed foods excluding that food group which you believe you may have an intolerance. For instance, for gluten intolerance or coeliac disease, you would abstain from eating any foods that contain gluten for a short period of time to see whether your body responds to the change in diet.

Treatment
The key to treatment is to exclude foods containing gluten from your food for life. If you are unsure about what to eat to maintin a balanced diet it would be wise to consult the appropriate health professional, such as a dietician, for advice. These days most foods are marked if they are gluten free and there are new ranges of food stuffs appearing in supermarkets and health food stores that are designed specifically for people who have coeliac disease or gluten intolerance.

Restaurants too are becoming more aware of the various needs of their clientele and a lot of restaurants have gluten free foods available on the menu and will be marked with the letters "GF" beside them indicating that they are gluten free.

What is Gluten and which foods have it?
Gluten is a highly complex protein that occurs in four main grains: Wheat, rye, barley and oats. Gluten is present in all types of wheat grain like whole grain wheat, wheat bran, spelt, triticale and others. This means gluten is also present in all baked foods that are made from these grains: bread, pies, cake, breakfast cereals, porridge, cookies, pizza and pasta. There are thousands of processed foods which contain gluten.

Gluten is one of the most complex proteins consumed by man. It is a very large molecule relative to other food molecules and for that reason is difficult for the human digestive system to break down.

What is Gluten-Free?
"Gluten-Free" foods are food stuffs so described:

a) Consisting of or are made only from ingredients which do not contain any prolamins from wheat or all Triticum species such as spelt, kamut, or durum, wheat, barley, oats, spelt or their crossbred varieties with a gluten level not exceeding 20 parts per million (ppm): or

b) Consisting of ingredients from wheat, rye, barley, oats, spelt or their crossbred varieties, which have been rendered "gluten-free"; with a gluten level not exceeding 200ppm: or

Any mixture of the two ingredients as in a) and b) with a gluten level not exceeding 200ppm.

A list of Gluten Free alternative food products:
Foods that are gluten free will have this fact listed on the label. The health food section in supermarkets will have gluten free foods available and your local health food store will often specialise in these food stuffs. But a good rule in general, even for those who do not suffer from the disease, is to always eat a balanced diet consisting of plenty of fresh fruit and vegetables (organic if possible) and to steer away from purchasing processed foods. You only have to look at the ingredients panel of a food product off the shelf and see for yourself that with a list that long, it cannot really be that beneficial to your health. If you are not sure what ingredients could potentially contain gluten there is information available for you.