Coeliac Disease Support
If you suffer from unexplained stomach trouble, like diarrhoea, bloating and pain; or extra-gastrointestinal symptoms of “unknown origin”, like anaemia, fatigue, osteoporosis or infertility, you may be intolerant to the dietary protein, gluten, found in wheat, barley and rye. Few people realise the seriousness of gluten intolerance, known as gluten-sensitive enteropathy or celiac disease. Without complete exclusion of gluten from the diet, celiac sufferers may be at increased risk for health problems, malignancies and death.
Celiac sufferers usually go undiagnosed, and so continue eating gluten for decades. The disease surfaces between infancy and adulthood but diagnosis is usually only made between the ages of 40 and 60 years, with 20% of cases diagnosed even later. This is because 50% of celiac sufferers have few or no obvious symptoms. Often, those that are apparent vary in presentation and onset so greatly that frequent misdiagnoses as irritable bowel syndrome, gallbladder disease or various other disorders are made, which may not even involve the gastrointestinal tract.
ANTIBODY BLOOD TESTS
Two antibody blood tests are used to diagnose celiac disease, but their accuracy varies depending on disease severity and which laboratory is conducting the tests. Human leukocyte antigen (HLA) typing can also help identify celiac disease. It’s a protein noticeboard that displays “wanted” signs for offending antigens, like gluten, to the body’s immune T-cells, ensuring that the immune system knows which proteins need to be attacked on sight. However, the only fail-safe way to diagnose celiac disease is by examining a sample of the small intestinal lining taken by biopsy during an upper gastrointestinal endoscopy (a little camera on a tube inserted through the mouth or nose).
POSSIBLE MANIFESTATIONS OF CELIAC DISEASE
Gastrointestinal symptoms – diarrhoea, bloating, pain, failure to thrive, fatigue, anaemia, osteoporosis, epilepsy, neurological disorders, liver disease, gall stones, infertility, arthritis, asthma, schizophrenia, psoriasis, hairloss (alopecia), premature grey hair, dental anomalies, weak immune system, hives, red or white inflammatory lesions in the mouth (oral lichen planus), inflammation of the heart sac (pericarditis) causing chest pain and fatigue, and red nodules on the skin (erythema nodosum).
The only treatment for celiac disease is complete gluten elimination by excluding wheat, rye and barely from the diet. Even a tiny amount of gluten, which may be hidden in food, can cause a relapse. Oats is the only other grain that may be of concern. While it doesn’t contain the offending protein, oats may be contaminated with wheat, barley or rye during harvesting, transport, milling or processing, and therefore may elicit an immune response. Most celiac sufferers report that symptoms abate after 2-8 weeks on a gluten-free diet, but for others, it may take months or even years.
So, if you have symptoms of unknown origin, make sure gluten isn’t behind it. Celiac sufferers should steer well clear of the offending grains and be careful of any food prepared by someone else. A gluten-free diet isn’t easy, but for the celiac sufferer it’s the only way to stay healthy. Read food labels carefully – if it doesn’t say “gluten free” and you’re unsure, contact the manufacturer for confirmation. Gluten could be hidden in some manufacturing processes.
The basic gluten-free diet
|Gluten-free grains – ALLOWED||Gluten-containing grains - AVOID|
|Arrowroot, amaranth, buckwheat, flax, corn (maize), legume flours (garbanzo/chickpea, lentil, pea), millet, nut flours (almond, hazelnut, pecan), quinoa, rice, rice bran, potato starch, potato flour, sweet potato flour, sago, seed flours (sesame), sorghum, soya, tapioca||Barley, bran, bulgar, couscous, durum flour, farina, gluten, gluten flour, graham flour, kamut wheat, malt products, most oats products, rye, semolina, spelt, wheat products, some additives/thickeners [e.g. dextrin (usually made from corn, but sometimes made from wheat), some flavourings, modified food starch, “starch” in supplements and pharmaceuticals, unidentified sources of hydrolysed protein]|
|AN AUTOIMMUNE DISEASE|
|If you’re genetically predisposed to it, gluten intolerance can surface when exposed to a trigger, such as gastrointestinal surgery, stress, pregnancy or viral infection, causing the immune system to react abnormally to gluten.|
|The immune system recognises gluten as a foreign antigen, produces antibodies and launches an autoimmune, inflammatory response against the small intestine lining and other body tissues – damaging these organs.|
|The inflammation damages the wall of the small intestine, reducing its ability to secrete the enzymes and hormones necessary for digestion, and make carriers needed to transport nutrients into the bloodstream. This can result in the nutrient deficiency symptoms often seen in celiac disease.|
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