What is coeliac disease?
To understand the damage that coeliac disease causes to the small intestine, we must first have a look at what the small intestine does. The surface of the small intestine is covered with millions of tiny finger-like projections called villi. Villi increases the surface area of the small intestine to maximise nutrient absorption as food passes through from the stomach.
In coeliac disease, your body’s immune system reacts abnormally to gluten, a protein found in wheat, rye, barley and oats. This can cause damage to the small intestines by causing the villi to become inflamed and flattened. As a result, the surface area of the intestines decreases, reducing the small intestine’s ability to absorb nutrients efficiently. This can lead to various gastrointestinal and malabsorptive symptoms.
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Figure 1 Images from Coeliac Australia[/caption]
Who can get coeliac disease?
Coeliac disease can affect people of all ages and both genders. However, it is a genetically linked condition. Whilst only 30% of Australians carry these genes, only 1 in 30 of these people will get coeliac disease. Environmental factors also play a role in triggering coeliac disease.
How common is it?
Approximately 1 in 70 Australians are affected by coeliac disease. However, a large number (approximately 80%) remain undiagnosed. With improvements in diagnosis, more and more people are being identified and given advice on how to manage their condition.
How do I know if I have it or not?
Symptoms of coeliac disease vary from person to person and symptoms can be similar to those of other medical conditions so it is important to get proper diagnosis from your doctor. Some people experience only one or multiple symptoms, whilst others experience none at all. Below are just a few of the more commonly experienced symptoms.
If you are concerned about having coeliac disease, speak to your doctor to get proper screening tests before starting a gluten free diet. It is important not to self-diagnose and start a gluten-free diet before being properly diagnosed by the doctor as the tests depend on a normal gluten intake.
Is there a cure?
Currently there are no cures for coeliac disease but it can be managed effectively through a lifelong strict gluten free diet. The removal of gluten from the diet allows the villi to heal and the symptoms to resolve. This may be a challenging process so it is important you have a great team of health professions including your doctor, pharmacist and dietician to provide you with the best support.
What happens if it is left untreated?
Leaving coeliac disease undiagnosed and untreated can lead to:
- Chronic systemic inflammation
- Poor nutrition
- Malabsorption of nutrients
Systems in the body can be affected include:
- Endocrine - glands
- Joints
- Blood
- Gastrointestinal
- Bone
- Liver
- Nervous system
- Skin and mouth
- reproductive
How do I know if the food I’m buying is gluten free?
Packaged foods must have an ingredient list printed on the label so check this list when you purchase any products. Whilst the label will most likely not list ‘gluten’ as an ingredient, look out for ingredients that do contain gluten – wheat, rye, barley and oats. Legally, all ingredients and food additives derived from wheat, rye, barley or oats must be declared on the ingredient list. Only foods that are tested and meet the Australian Food Standard of having ‘no detectable gluten’ are labelled “gluten free”. Below are four categories to help identify gluten-free foods.
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Figure 2 Ways to identify gluten-free food.[/caption]
Some unexpected sources of gluten include:
- Stocks and sauces
- Soy milk
- Icing sugar, dusting chocolate
- Salad dressings
- Chicken salt
- Dusting/coating flour
- Oil that is used for other purposes
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Figure 3 Coeliac Australia endorsement logos. Images from Coeliac Australia[/caption]
How do I know if the food from restaurants is gluten free?
Some restaurants offer a gluten-free menu. If not, always ask them about their gluten-free options. Below are a few examples of questions you may find helpful when dining out.
You can also find a list of suggested restaurants on the Coeliac Australia website.
Will my change in diet affect my nutritional intake?
It is still possible to have a nutritious and balanced diet if you have coeliac disease. It is also possible to vary your meals by experimenting with the ingredients available to you. A dietician may provide some suggestions that would suit your individual needs.
Alternatively there are some gluten-free nutritional supplements available that can add to your nutritional intake. They come in simple sprinkles which can be added to your dishes or delicious smoothies and soups. Below are just a few examples that can be found at your pharmacy.
Important points
