Coeliac Disease

Do you have unexplained digestive pain, skin rashes, joint pain, iron deficiency, or bone and muscle pain or even chronic fatigue? Varying symptoms like this could be Coeliac disease! Coeliac disease is a serious autoimmune disorder and triggers the immune system to react to ingested gluten (a protein found in wheat, barley, rye and oats) damaging the wall of the small bowel. Basically the immune system produces antibodies against gluten! Over 1 in 70 of the Australian population have the disease with 80 per cent of affected individuals remain undiagnosed.

The risk of developing coeliac disease is increased if you have a family history of the disease.

What Happens When A Coeliac Eats Gluten?

It’s all in the GUT! Coeliac symptoms are often associated in the gut and digestion but other areas can be effected giving symptoms such as brain fog, painful joint and muscles, fatigue, weakness, depression, allergies, osteoporosis, anxiety and other chronic health conditions. When a coeliac ingests gluten containing food an inflammatory immune response to gluten will occur. The immune system also attacks the tissues in the small intestine in the process of getting rid of the gluten. We have tiny projections, called villi, that line our digestive tract these increase the area of absorption for nutrients making it very efficient, but for a coeliac this immune activation inflames and destroys the structure of the villi causing erosion or flattening of the villi which means we can’t absorb nutrients like we should.

Foods to eat on a gluten free diet?

For a coeliac diet should focus on reducing the inflammation, healing  to repair the villi or mucosal lining  of the digestive tract and this will begin to correct any nutritional deficiencies. Treatment is to remove gluten from the diet. Additionally you can add certain nutrients to restore the health of the gut.

Include… as many naturally occurring gluten free foods!

• Fresh fruits
• vegetables
• meat, fish, poultry
• eggs & dairy
• nuts & seeds
• lentils & legumes
• Probiotic foods (sauerkraut, kefir, tempeh, kombucha, yoghurt)
• Prebiotic foods (onion & garlic)
• May be some naturally gluten free grains such as rice, corn, millet, amaranth

Support

Since gluten can be very sneaky and not easily detected in pre-packaged foods, it helps to educate yourself on what foods and products are safe to consume. The Coeliac Disease Foundation (https://www.coeliac.org.au/ ) offers support in this area.

Common Foods That Contain Gluten

• Wheat – found in pasta, breads, biscuits, cereals, snack bars, baking flours, packaged foods
• Rye
• Barley
• Oats
• Up to 25% of gluten free grains can be contaminated, even when specified on the label.
• Alcohol – beer
• Sauces – many contain gluten
• Eating out – be mindful of contamination, sauces, foods which are floured
• Cross contamination – toasters, pots and pans

You MUST read the labels of foods to clarify if there is any hidden gluten!

Testing?

It is really important to determine if you are a coeliac as opposed to being gluten intolerant, this is because those who are intolerant can often improve tolerance with improvements made to gut health and function, coeliac’s can’t.

Two types of tests can be helpful in trying to work out if gluten is a problem for you:

• Coeliac serology – looks for antibodies against ingested gluten made by our immune system and
• Coeliac genotyping – HLA DQ2/ DQ8 gene testing

The coeliac serology must be done while one is still eating gluten. The results of these tests will go some way toward determining if a biopsy, performed by a gastroenterologist, is required. The biopsy is used as our current standard for officially diagnosing coeliac disease, and you must be eating gluten prior to testing. This also means coeliac disease can go undiagnosed if you stop eating gluten prior to proper testing.

Can I Still have Symptoms with a Negative Result?

Just like other food intolerance you can be gluten intolerant without having coeliac disease. This can cause bloating and many other symptoms too and is more common. Something called Non-coeliac gluten sensitivity (NCGS) is also a real condition characterised by gut but also skin, brain, liver, joint, muscle and endocrine symptoms that are specifically triggered by gluten containing foods in those who are not officially coeliacs.

Its worth noting that identifying exactly where you stand in terms of gluten is important, especially if you have a chronic disease or digestive issues, other signs to indicate your tolerance to gluten include those with autoimmune disorders, allergies, other immune issues, weight loss with no known cause, osteoporosis/osteopenia, fatigue with no known cause and vitamin B12/iron/protein deficiencies. Part of the reason is because flattened villi seen in coeliac disease can lead to malabsorption of important nutrients  vital for the functioning of all our body and organs. Another reason is that the immune activation seen in coeliac and NCGS causes wide spread inflammation and disruption or disregulation of normal healthy immune function.

REFERENCES

Gluten-free diet

Advances in Celiac Disease

Gluten sensitivity

Celiac Disease Foundation

Diagnosis of Non-Celiac Gluten Sensitivity

Non-coeliac Gluten Sensitivity

The Biochemical Basis of Celiac Disease

Neurological Illness

Neurological Abnormalities and Gluten-Free Diet