Coeliac Disease is a medical condition associated with a life long intolerance to dietary gluten. It is estimated that 1 in 100 people in Australia may suffer from coeliac disease (CD), although only 10 – 20% of these people are currently diagnosed, and it may present at any age. It is generally a disease suffered by people of Anglo-Saxon and European background. The cause is unknown, however genetic and environmental factors play a role.In CD, gluten, a protein found in grains such as wheat, triticale, rye, oats and barley, causes damage to the mucosal wall of the small intestine, leading to the inadequate absorption of nutrients and hence conditions related to malnutrition. Once gluten is eliminated from the diet, the gut wall repairs itself but individuals must follow a strict, life long gluten free diet to prevent damage reoccurring. For this reason, interpreting ingredient lists and reading labels become a way of life. When a family member is diagnosed with CD, the entire family will commonly also revert to eating gluten free products (not just the individual who has been diagnosed). Initially, it can be a challenge to find gluten free foods that not only taste good, but are accepted by the whole family. What are the symptoms?
As absorption of nutrients can be impaired in undiagnosed or untreated CD, sufferers commonly experience: › Chronic diarrhoea or constipation › Weight loss › Vomiting › Stomach pain › Bloating & flatulence › Anaemia. Other symptoms can include: › Headaches and migraines › Mouth ulcers › Fatigue / lethargy › Muscle and joint pain › Growth retardation in children. CD is also occasionally accompanied by a blistering and itchy skin condition called dermatitis herpetiformis, which can appear and subside seemingly spontaneously without treatment. It is important that people with CD do not believe it safe to consume some gluten containing foods even if they do not experience any obvious symptoms. Some individuals have severe symptoms and little cell wall damage, others have none or minor symptoms, however mucosal damage may be severe.
How is coeliac disease detected? Blood testing for gluten antibodies can be used for initial screening for CD. However, for confirmation of the presence of the disease, patients need to have a small bowel biopsy following a gluten-containing diet. Prior to testing, gluten containing foods must still be included in the diet, as removing them can result in the gut healing itself, and CD not being detected.
How is Coeliac Disease treated? Currently, there is no cure for CD and sufferers need to adhere to a life-long, gluten free diet. Avoiding gluten in the diet allows the bowel to repair itself and nutrient absorption to return to normal. Failure to comply with the gluten free diet can increase the risk of developing conditions such as osteoporosis, infertility and malignancy, as well as impaired growth and development in children. For information on gluten containing foods refer to the gluten free diet fact sheet. Note that wheat allergy and wheat intolerance are unrelated to CD and do not require a gluten free diet.
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