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
