COELIAC DISEASE

Celiac disease, also known as gluten intolerance, is a significant medical condition that can result in a number of serious consequences if not diagnosed and treated properly. Gluten is a protein found in grains including wheat, rye, oats and barley. Patients with Coeliac disease are sensitive to gluten which damages the lining of the small bowel. This damage affects the absorption of food and can lead to symptoms including weight loss, diarrhea, iron and folic acid deficiency.  

The symptoms of coeliac disease can range from severe to minor or atypical and may even go undetected. Some symptoms can incorrectly be confused with irritable bowel syndrome or wheat or other food intolerance, while others may be put down to stress or getting older. 

Coeliac blood tests can be used for initial screening. If the results are positive, a referral to a gastroenterologist will be necessary. The diagnosis must be confirmed by performing a gastroscopy, a procedure that allows tiny samples (biopsies) to be taken from the small intestine. This procedure occurs while the person is under sedation and involves an endoscope being passed through the mouth into the small intestine.

A gluten free diet is the only long term treatment for coeliac disease. This strict attention to diet must be lifelong. Complete removal of gluten from the diet allows the gut to recover to normal over a period of time. Even small amounts of gluten are enough to prevent recovery or cause further damage.

The most obvious sources of gluten in the diet are bread, pasta, breakfast cereals, flour, pizza bases, cakes and biscuits. Gluten can also be found in foods such as soups, sauces, ready meals and processed foods such as sausages. It is essential that a person with coeliac disease becomes ‘ingredient aware’. The guidance of an accredited practising dietitian, who can give assistance with advice to suit individual needs, is recommended.

The gluten-free diet is made up of:

• Naturally gluten-free foods such as meat, fish, fruit and vegetables, rice, potatoes and lentils.
• Processed foods which don't contain gluten.
• Gluten-free substitute foods such as specially made gluten-free bread, flour, pasta, crackers and biscuits.

Cross-contamination occurs when gluten-free foods come into contact with foods that contain gluten. It can happen during the manufacturing process, for example, if the same equipment is used to make a variety of products. Some food labels include a "may contain" statement if this is the case. But be aware that this type of statement is voluntary. You still need to check the actual ingredient list. If you're not sure whether a food contains gluten, don't buy it or check with the manufacturer first to ask what it contains. 

The time it takes for someone to feel better on a gluten-free diet varies. Many people feel better within a few days and usually symptoms like nausea, diarrhea and bloating clear up within a few weeks. 

Some symptoms may take longer to improve, or you may find one symptom gets better before another. The time it takes for the gut damage to heal completely varies and can take between six months and two years.

By Sonia Marañón