Supermarkets, pizza places and bakeries are all now catering for gluten-free customers. Gluten-free is not just a fad but the result of a potentially serious and surprisingly common condition - coeliac disease. Coeliac disease is a condition where sufferers have an intolerance to gluten – a protein found in certain grains that enables the dough to rise such as in bread and pasta. That means that these people cannot digest gluten (or its by-product, alpha-gliadin). If consumed it damages their intestinal wall, causing reduced absorption of nutrients.
For sufferers of coeliac disease, the body mistakes gluten for a harmful substance so consequently produces antibodies to fight it. This causes inflammation and damage to the small intestine and can prevent the small bowel from absorbing nutrients and minerals. Coeliacs are born with a genetic predisposition to the disease. They inherit a genetic make-up (HLA type) with "coeliac genes" DQ2 and DQ8. Other factors include being of European descent and having another medical condition related to problems with the immune system such as Type 1 diabetes.
Coeliac disease affects about one in 100 people in Australia and is commonly diagnosed in women during their 30s as it is believed that stress during this decade can bring it on. Many people are believed to be subclinical, where their symptoms are mild so the condition remains undetected. If left untreated for too long it can cause serious problems such as malnutrition and osteoporosis.
The symptoms of coeliac disease can be mild to severe and are often similar to other conditions such as irritable bowel syndrome. Symptoms include fatigue, digestive disturbances and anaemia. Other symptoms include diarrhoea or constipation, weight loss, nausea and vomiting, and wind. Children with the disease may also be tired and irritable, have slow growth, a swollen abdomen and experience weight loss.
To diagnose coeliac a doctor will examine you and discuss your symptoms and medical history. A blood test checks for antibodies against gluten. If the test is positive you will be referred to a gastroenterologist for an intestinal biopsy, which is where a narrow tube with a camera attached is inserted from the mouth into the small intestine to take samples of the bowel lining. Correct diagnosis is made by proving that the bowel lining is damaged.
Coeliac disease is a lifetime condition which requires strict adherence to a gluten-free diet. Sticking to a gluten-free diet is a lifetime commitment and getting advice from a dietician is recommended. Gluten is found in foods made using wheat, barley or rye. Hence, coeliacs should avoid grains such as wheat, spelt, rye, barley, triticale and oats as they contain gluten. Gluten-free grains include rice, corn, potato, buckwheat, quinoa, amaranth, millet and legume-based flours. All fruits, vegetables and legumes are gluten-free.
To manage the condition people with coeliac disease also need regular check-ups and blood tests to make sure they're absorbing nutrients. To repair the damaged digestive system, a range of treatments can be used such as the amino acid glutamine; vitamins A, E, D, K and C; minerals zinc and iron; probiotics (acidophilus and bifidus species); slippery elm and aloe vera, and herbal bitters to increase digestive enzymes. Formulations that include such elements are Blooms L-Glutamine, Nature’s Own Zinc Chelate, VitaScience Slippery Elm and Caruso’s Gut Defence and Blackmores Digestive Bitters. Stress management is also vital.