Coeliac Disease

Coeliac disease is an autoimmune condition where the immune system mistakes substances found inside gluten as a threat to the body and attacks them. This damages the surface of the small bowel (intestines), disrupting the body's ability to absorb nutrients from food. Exactly what causes the immune system to act in this way is still not entirely clear, although a combination of a person's genetic make-up and the environment appear to play a part.

 

Gluten is a protein found in three types of cereal:

  • Wheat

  • Barley

  • Rye

 

Gluten is found in any food that contains the above cereals, including:

  • Pasta

  • Noodles

  • Cakes

  • Breakfast cereals

  • Bread

  • Certain types of sauces

  • Some types of ready meals

  • Ice cream

  • Chocolates

  • Soy sauce

 

Increasing numbers of adults are being diagnosed with coeliac disease, whereas years ago it was considered to be a disease that was only diagnosed in children. Coeliac disease can present at any age, and the variability and often vagueness of symptoms can present a diagnostic challenge to many medical practitioners.

 

Symptoms can include:

  • Loose stools/diarrhoea, or constipation (or a combination of both)

  • Bloating

  • Abdominal pain

  • Nausea

  • Lethargy and fatigue

  • Poor weight and growth gain in children

  • Iron, folate, zinc, Vitamin D deficiency

  • Osteopaenia and osteoporosis.

  • Delayed menarche or recurrent miscarriages in women

  • Infertility (in males and females)

  • Recurrent mouth ulceration

  • Dental enamel defects

  • Hair loss

 

Diagnosis

 

The gold standard for diagnosis is a small bowel biopsy (the doctors will look for histological evidence of villous atrophy +/- infiltration of lymphocytes). This involves a special camera being passed down the oesophagus, past the stomach, and into the first part of the small bowel. There, small samples of the lining of the small bowel are taken and investigated under the microscope. If the biopsy samples show flattening of the lining, then it confirms coeliac disease.

 

Once the diagnosis of coeliac disease has been made, the following tests are recommended if not already completed: full blood examination, iron studies, folate, vitamin B12, zinc, vitamin D levels and bone mineral density. People with celiac disease can also have lactose intolerance, fructose malabsorption, problems with their thyroid gland (underactive, overactive) and diabetes.

 

Gluten Free Diet

 

Coeliac disease is a life-long condition and there is currently no cure. The only treatment available is a diet free from all gluten. A gluten free diet for coeliac disease prevents further damage to the intestinal lining, allowing villi to heal so that nutrients from food can be properly absorbed. People need to follow the diet even if they are not unwell with symptoms. It must be strict and lifelong – people cannot take a break every now and then and have a bowl of regular pasta, or a slice of regular bread.

 

If left untreated, people with coeliac disease can be at an increased risk of bowel cancer, osteoporosis, infertility, miscarriages and chronic ill health. The risk of all of these returns to normal on a gluten free diet. The gluten free diet can be challenging and difficult, especially for the first few months following diagnosis, but it progressively becomes easier with familiarity with the diet and the foods available grows over time.

 

All the recipes on HealthyLittleK are gluten free.

 

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