Coeliac disease is a condition in which the immune system reacts abnormally to a protein called gluten, causing damage to the small intestines. The tiny, finger-like projections which line the small intestines become inflamed and flattened. Consequently, nutrient absorption is impaired, and symptoms of malnutrition can result. It is not a food allergy but an auto-immune disease.

 

What is Gluten?

 

A protein found in certain common grains:

• wheat (and its derivatives e.g. triticale, kamut, spelt)

• barley (and its derivatives e.g. malt)

• rye

• oats

 

Obvious sources of Gluten include breads, cakes, biscuits, pastry, pizza, pasta, batter and breadcrumbs, unless made from gluten-free grains. Beer also contains gluten. Gluten may be found in processed meats (e.g. sausages, rissoles), cornflour (from wheat), stocks, gravies, icing sugar mixture, mayonnaise, vinegars, mustards and pickles.

 

Coeliac disease compared to Non-coeliac gluten sensitivity

 

You must be born with the genetic predisposition to develop coeliac disease. The most important genes associated with susceptibility to coeliac disease are HLA DQ2 and HLA DQ8. You can get these tested via a blood test through your GP. Coeliac disease is usually confirmed through the presence of antibodies IgG and IgA (also found through a blood test), as well as a biopsy of the small intestines.

A condition of gluten sensitivity/intolerance can occur in individuals too. Gluten is one of the most complex proteins we consume. It is a very large molecule relative to other food molecules and, for this reason it is difficult for the human digestive system to break down. The current understanding of gluten sensitivity is that the body views gluten as an invading substance and fights it with inflammation both inside and outside the digestive tract, and perforation of the lining of the gut occurs, creating a condition called Leaky Gut Syndrome. This allows foreign particles (whatever is in the gut, including bacteria) into the bloodstream which sets the body's immune system on 'high alert', resulting in a wide range of symptoms.

 

Why is it a problem?

 

Anyone diagnosed with coeliac disease or gluten intolerance/sensitivity would benefit from seeing a Dietitian for our expertise on:

• What to eat and how to avoid gluten-containing foods,

• How to read food labels and interpret the ingredients list to avoid the less obvious gluten-containing ingredients,

• Safe food handling and avoid cross-contamination,

• How to eat out safely and what to buy

• Travel tips

• Navigating takeaways and dining out

 

Unfortunately, gluten-free foods are not necessarily nutrient-rich foods, so being educated on how to choose healthy gluten-free foods is paramount for a healthy body.

 

It is also important to restore nutrients that may have been lost prior to diagnosis, and our dietitians can assist in this too.