Coeliac Disease: The gluten-free lifestyle
Coeliac Disease can sound quite scary to those who may not know what it is. By all rights, coeliac disease is a serious condition as it is classified as an autoimmune disease. Those with Coeliac Disease are unable to normally process gluten. When gluten is ingested, the body mistakes it as a threat and subsequently triggers an immune response which causes damage to the small bowel.
Coeliac Disease is not new, dating back to the 1880’s. Since its discovery, many different diets were used to manage the symptoms. The correlation between Coeliac Disease and gluten was discovered in 1953 and from then, gluten free diets began being used for those with the disease. Coeliac Disease affects about 1 in 70 Australians, but about 80% go undiagnosed. As the disease is becoming more recognised, there has been some increase in those diagnosed.
What happens in our gut?
Coeliac disease means the body sees gluten as a threat and attacks it. Whilst the body is trying to attack gluten, damage to villi occurs, which are small finger-like projections that line the intestines. The villi are extremely important as they help to absorb the nutrients in the foods when we eat. Unfortunately, when damaged, the villi do not function and thus important nutrients may not be well-absorbed.
Symptoms of Coeliac Disease
In most cases, those with Coeliac Disease experience symptoms which alerts them to seek medical attention. The most common symptoms include;
Diarrhea and/or Constipation
Extreme Tiredness and Fatigue
Rashes such as dermatitis
Anxiety and/or Depression
For some people, symptoms are so mild or even asymptomatic. It is important to know the risk factors including having family with Coeliac Disease, having another autoimmune disease or having the coeliac gene (HLA-DQ2 and HLA-DQ8). If these risk factors apply to you and you have symptoms associated with Coeliac Disease, it is a good time to have a chat with your GP to further explore.
What if I don’t treat my Coeliac Disease?
One of the biggest issues of untreated Coeliac Disease is gut issues and nutrients from food not being absorbed properly, which may lead to malnutrition. Malnutrition can lead to osteoporosis and anaemia. Additionally untreated coeliac disease can cause complications such as development of another autoimmune disease, thyroid disease and certain malignancies. Aim to get checked out by your doctor if you have any symptoms or risk factors.
How will I be diagnosed with Coeliac Disease?
Many people self-diagnose and give up gluten unnecessarily. It is vital that you speak with your doctor if you suspect that you have Coeliac Disease, for a formal diagnosis.
For a doctor to diagnose Coeliac Disease, you need to be consuming gluten at the time of testing, so if you go to your doctor after eating gluten-free your results may be inaccurate. To test for Coeliac Disease, a doctor will take a blood test initially, if the results are positive an upper endoscopy with biopsies may be undertaken to follow up and confirm the diagnosis.
What happens when my diagnosis of Coeliac Disease has been confirmed?
There is currently no cure for Coeliac Disease. There are no surgeries or medications which can currently help treat the condition. The only known treatment is by following a life-long strict gluten-free diet.
What is gluten?
Gluten is a protein which is found in wheat, rye, barley, oats and triticale. It is found in most of the cereals and in many processed products.
Wheat is a staple of a western diet and can be found in baked goods, breads, pasta, cereal, sauces and dressings. Barley is commonly found in malt, food colour, soup, beer and brewers yeast. Rye can be found in rye bread, pumpernickel, cereals and certain beer. Triticale is often in bread, pasta and cereal. Oats are technically gluten free, however due to farming they often become contaminated with gluten. Those who have Coeliac Disease should have zero traces of gluten and can be affected by foods contaminated with gluten.
How to follow a gluten free diet?
Following a gluten free diet involves cutting all wheat, rye, barley and triticale from your diet. Luckily with more awareness in our modern society, there are many commercial brands which cater for a gluten free diet and produce products including breads, cereals, pasta and baked goods.
Coeliac Disease can be triggered by the smallest amount of gluten, therefore it is recommended to use separate bread boards, utensils, toasters and equipment. Shared items need to be thoroughly washed to avoid cross contamination.
If diagnosed with Coeliac Disease, reach out to an Accredited Practising Dietitian (we have a bunch of them who can help!) for support with your journey and to guide you to ensure you are meeting your nutritional requirements.
By Simone Cammarere, Accredited Practising Dietitian for OSCAR Care Group