Gluten intolerance and Coeliac Disease |
| FAQ |
Aspects |
Answers |
Comments |
| How common is Coeliac Disease? |
Occurrence |
Around 0.5% of the world’s population is coeliac. In Australia this means ~100,000 people or about 1 in 200 people. There are many others who are Gluten Sensitive and suffer many Coeliac symptoms, whose biopsies have not clinically confirmed Coeliac Disease. |
Occurrence of CD in elderly patients seems disproportionately high but is probably due to undiagnosed gluten intolerance. CD is known to become worse with age. |
| What are the symptoms of Coeliac Disease? |
Symptoms |
Gastro-intestinal (diarrhoea, flatulence, bloating etc.) and associated malabsorption problems like anaemia. In some Coeliacs: Dermatitis Herpetiformis (DH): extremely itchy weeping pustules on the skin. See the Symptoms Matrix |
Because the symptoms overlap with many other ailments, Coeliac Disease can be missed or misdiagnosed. CD is poorly diagnosed in Australia. |
| How is Coeliac Disease identified? |
Diagnosis |
Clinical diagnosis: Initially a blood test. If suspected then a biopsy of the small intestine is done. If the villi are damaged in a characteristic way then Coeliac Disease is confirmed. After that a “food challenge” is carried out: gluten is re-introduced to the diet for a period of weeks. Then a further biopsy is carried out to confirm that the villi have been damaged again. This is a clinical diagnosis of CD. |
Some people discover they are Gluten Sensitive or Coeliac by trying an Elimination Diet |
| How did I get Coeliac Disease? |
Causation |
Generally CD is ‘in the family’, or genetically inherited. Indicators are European or Anglo-Celtic ancestry. As much as 10% of the immediate family is likely to be Coeliac, even if they don’t have any symptoms. A blood test may be wise for such family members. |
A few Coeliacs are identified as children. For others, it is not until much later in life that gluten intolerance or sensitivity is actually suspected. Often the indicator is anaemia and/or iron therapy failure. |
| How is Coeliac Disease treated? |
Treatment |
No drug therapy required. Only dietary changes to exclude gluten for life. This means a gluten-free diet – the exclusion of all foods and pharmaceuticals that contain gluten. |
Gluten-free products now appearing more frequently on supermarket shelves. But access to Gluten-free pharmaceuticals is more difficult. Vigilance is needed to ensure a GF diet. |
| When will I be cured from Coeliac Disease? |
Prognosis |
There is no cure for CD. However, provided you stick to a gluten-free diet you should experience complete recovery – healing of the damaged small intestine allowing full absorption of nutrients. Iron levels should slowly get back to normal. |
Even with only a few weeks on a gluten-free diet, many Coeliac and gluten sensitive patients report feeling better than they have for years. |
Gluten is one of the most complex proteins consumed by man - and is therefore extremely difficult to digest. This is why babies first introduced to solid foods are not given wheat. They are started on a thin porridge of rice because their tiny digestive tract can process it easily.
People with Gluten intolerance are unable to digest gluten – a protein found in wheat, rye, barley and oats. In fact in coeliacs this protein actually attacks the lining of the small intestine causing damage that flattens out the tiny villi (finger-like protrusions which provide most of the surface area for nutrient absorption.)
Gluten intolerance can be difficult to identify and diagnose with blood tests and medical investigations.
But it is easily identified with the tried and proven Elimination Diet. Doctors know Elimination Diets work, because they use them to confirm or disprove others investigations like blood tests and biopsies.
For the small percentage of Gluten sensitive people who are coeliac to be clinically diagnosed there must be a positive coeliac blood test AND damage caused to the villi in the small intestine as a result of exposure to Gluten, (the biopsy examination).
The only treatment for any Gluten Sensitivity is to alter eating habits to exclude Gluten: a Gluten-free diet.
How to go Gluten-free? Have a look for The Compleat Guide to Gluten-free in The Tuesday Club.
 One result of damaged intestines is the possibility of additional Food Intolerances. It can affect the ability to digest milk and milk products – dairy intolerance. Lactase, the enzyme necessary for the breakdown of lactose in dairy foods is produced in the tips of the villi, in the small intestine.
When the villi are damaged, as in Gluten intolerance then intolerance to milk products is likely.
Dermatitis Herpetiformis (DH) is another form of Gluten intolerance and affects the skin by forming lesions that are watery and itchy blisters. DH only presents when the patient has inherited the gene. In this case they may or may not have the intestinal symptoms as described above.
Other diseases associated with Gluten intolerance are auto-immune diseases like rheumatoid arthritis, diabetes mellitus, autoimmune thyroid disease, and cancers of the intestine.
It is also a cause of infertility, miscarriage and other serious conditions. See Health Risks.
Eating Gluten-free means finding substitutes for wheat, oats, barley and rye.
However, after a few weeks on a gluten-free diet newly diagnosed Gluten sensitive people find they are free of a raft of other symptoms as well which for years had compromised their lifestyle: flatulence, abdominal cramps, tiredness and their tendency to catch ‘bugs’ and viruses easily.
It is surprising how quickly the small intestine actually heals. Soon you will begin to absorb nutrients from food more effectively. The digestive tract gets back to doing its job normally and you will start feeling well again.
How to go Gluten-free? We have The Compleat Guide to Gluten-free in The Tuesday Club.
Symptoms Matrix (you must register first)
The Compleat Guide to Gluten-free
Remember - for great tips and info on Food Intolerance sign up for our newsletter - it's free!
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