According to Coeliac UK, 1 in 100 people worldwide have coeliac disease with only 36% of those diagnosed with the condition, leaving around 500,000 people undiagnosed and living with debilitating symptoms.
What is Coeliac Disease?
Coeliac disease, pronounced see-liac, is a complex autoimmune condition where your body’s immune system mistakenly attacks the lining of the small intestine in response to the ingestion of gluten.
Within the small intestine are what’s called villi; small finger-like projections that are responsible for absorbing nutrients from the food you eat. In people with coeliac disease those little villi atrophy and flatten out which hinders their ability to absorb nutrients leading to further health complications such as malnutrition, osteoporosis, anaemia, peripheral neuropathy, fertility complications, lactose intolerance and cataracts.
Individuals with coeliac disease have specific genes that make them more susceptible to developing the condition so having one autoimmune disorder increases the likelihood of developing another. Coeliac disease is frequently found in conjunction with other autoimmune conditions such as Type 1 diabetes and autoimmune thyroid disease. Since coeliac disease has a hereditary genetic component, the likelihood of developing the condition increases to 1 in 10 for individuals with a close family member who has been diagnosed with it.
Symptoms of Coeliac Disease
Coeliac disease presents with a wide variety of symptoms such as bloating, diarrhoea, nausea, wind, constipation, tiredness, mouth ulcers, sudden or unexpected weight loss (but not in all cases), and anaemia and can often be misdiagnosed as irritable bowel syndrome.
If you experience any of these symptoms you can take a free online assessment with Coeliac UK here
It is important to remember that coeliac disease is not an allergy or a food sensitivity.
Some people can have a sensitivity to gluten and not have coeliac disease.
Potential Nutritional Deficiencies in Coeliac Disease
It is common for some people to have nutritional deficiencies because of the damage to the small intestine. Deficiencies in iron, folic acid, vitamins B6 and B12, vitamin D, copper, and zinc can also occur in people who consume gluten free versions of highly processed items like bread, pasta, cakes, and cookies and consume very little nutritious wholefoods. In this case a comprehensive supplement plan should be considered alongside ensuring the diet is as optimal as possible.
What is Gluten and Which Foods Contain It?
Gluten is the collective term used to describe a series of proteins found in wheat, barley, rye and in some cases, oats*. The most recognised gluten proteins are gliadin and glutenin and are often used as binding agents in processed foods to improve texture, moisture retention and improve flavour.
Gluten is found in several grains, including:
Wheat: This is the most common source of gluten and is found in various forms such as whole wheat, wheat flour, wheat germ, and wheat bran. Foods like bread, pasta, couscous, flour tortillas, and baked goods are typically made from wheat.
Barley: Barley contains gluten and is commonly used in malt products, malt vinegar, beer, and certain breakfast cereals.
Rye: Rye is another grain that contains gluten. It's commonly found in rye bread, rye crackers, and some types of whiskey.
Triticale: This is a hybrid grain derived from wheat and rye, so it contains gluten so may also contain gluten.
Spelt: Spelt is an ancient grain related to wheat and contains gluten. It's often used in bread, pasta, and baked goods.
*Oats: While oats themselves are naturally gluten-free, they are often processed in facilities that also handle wheat, barley, and rye, leading to potential cross-contamination.
As gluten is often used as an additive it can also be found in foods that you might not expect such as soups, sauces, spices mixes, ice cream, chocolate bars, some medications, and personal care products.
What to Do if You Think You are Coeliac?
The first step in the diagnosis process is to discuss testing for coeliac disease with your GP. You may be offered a blood test. The test looks for the antibodies produced by people with coeliac disease when they eat gluten.
Your doctor may advise you not to remove gluten from your diet as it is essential to keep eating gluten before and throughout the testing process, otherwise your body may not produce antibodies, and you could get a false negative result.
Speak to you doctor about any symptoms that you are experiencing and take a copy of your online assessment with you from the Coeliac UK website here.
What Happens after Coeliac Disease Diagnosis?
Following a positive diagnosis from your healthcare team you will be prescribed a strict gluten free diet for the rest of your life. In some people cross contamination from other householder’s chopping boards, toasters, and other kitchen items in contact with gluten can trigger the condition so it is important to have separately labelled items at home to avoid contamination.
You will become an expert in reading product labels and looking for and become familiar with hidden gluten within the foods. An excellent resource is Coeliac UK.
Sticking to a whole food diet from nature is the surest way to eliminate gluten as gluten is mostly found in highly processed foods such as pre-made sauces, soups, condiments, biscuits, ready meals, sausages, burgers as well as bread, pasta, pizza, and baked goods
You may also be assigned a dietician or nutritionist to help you navigate your new gluten free world.
