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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. Over 1 in 70 of the Australian population have the disease with 80 per cent of affected individuals remain undiagnosed.

The risk of developing celiac 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! Usually symptoms start in the digestive tract. A coeliac will ingest gluten containing food where an inflammatory response to gluten will occur, the immune system overreacts and attacks the tissues in the small intestine. In the digestive tract we have tiny projections (called villi) which increases the area of absorption of nutrients making it very efficient, but for a coeliac this immune activation inflames and flattens the villi resulting in malabsorption and nutrient deficiency.

 

Coeliac Disease symptoms usually include

Serious conditions associated with Coeliac Disease

 

·         Gastrointestinal symptoms- constipation, diarrhea, nausea, vomiting, flatulence, bloating, pain and cramping

·         Iron deficiency, anaemia and other vitamin and mineral deficiencies

·         Fatigue/lethargy

·         Weight loss or weight gain

·         Bone and joint pain

·         Disturbed sleep

·         Headaches/migraines

·         Irritability, decreased alertness

·         Ulcers, swelling of tongue/mouth

·         Skin rashes

 

·         Type 1 diabetes

·         Thyroid conditions

·         Liver disease

·         Early onset osteoporosis

·         Unexplained infertility

·         Osteoporosis

·         Multiple sclerosis

·         Heart palpitations

·         Anxiety/depression

·         Addison’s disease

 

 

Foods to eat on a gluten free diet?

For coeliac’s, diets should focus on reducing the inflammation along with a gut healing diet to repair the digestive tract (in particular gut lining) and correct any nutritional deficiencies.

Include… as many naturally occurring gluten free foods!

  • Fresh fruits
  • vegetables
  • meat, fish, poultry
  • eggs & dairy
  • nuts & seeds
  • Probiotic foods (sauerkraut, kefir, tempeh, kombucha)
  • Prebiotic foods (onion & garlic)
  • 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 Celiac Disease Foundation (https://www.coeliac.org.au/ )offers support in this area.

Common Foods That Can Contain Gluten

  • Wheat – found in pasta, breads, biscuits, cereals, snack bars, baking flours, packaged foods
  • Rye
  • Barley
  • Oats
  • Certain 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 improve tolerance with improvements to gut function, coeliac’s can’t.

Testing coeliac serology (antibodies which rise when gluten is ingested) and coeliac genotype is a great start. 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 (a gastroenterologist will perform this test) is required. Its important to note only a biopsy can confirm coeliac disease, and you must be eating gluten prior to testing.

Coeliac disease can go undiscovered if you come off gluten prior to testing appropriately.

I Still Have Symptoms With A Negative Result?

You can be gluten intolerant without having coeliac disease, just like any food intolerance and this can cause bloating and many other symptoms. Non-coeliac gluten sensitivity (NCGS) is also a syndrome characterised by intestinal and other symptoms related to ingestion of gluten foods in those who are not coeliacs nor have wheat allergies.

Its worth noting that identifying exactly where you stand in terms of gluten is important, other than digestive issues, other markers to instigate your tolerance around gluten, would include those with autoimmune disorders, allergies, other immune issues, weight loss with no known cause, osteoporosis/osteopenia, fatigue with no known cause, vitamin B12/iron/protein deficencies. Because flattened villi leads to malabsorption of nutrients, coeliac disease can effect any system/organ in the body!

 

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