Articles
Coeliac Disease
In people with coeliac disease the immune system reacts abnormally to gluten (a protein found in wheat, rye, barley and oats), causing small bowel damage. The tiny, finger-like projections which line the bowel (villi) become inflamed and flattened. This is referred to as villous atrophy. The surface area of the bowel available for nutrient absorption is markedly reduced which can lead to various gastrointestinal and malabsorptive symptoms.
A number of serious health consequences can result if the condition is not diagnosed and treated properly.
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. Either one or both of these genes are present in virtually every person with coeliac disease. Only 1 in 30 people (approximately) with one or both genes will get coeliac disease.
Environmental factors play an important role in triggering coeliac disease in infancy, childhood or later in life.
Symptoms
The symptoms of coeliac disease vary considerably. Common complaints include gastrointestinal upset (such as abdominal pain, bloating, flatulence, nausea, vomiting, diarrhoea and/ or constipation), lethargy, mouth ulcers and weight loss. Some people suffer severe symptoms, while others are symptom free. Further investigation for coeliac disease should occur if one or more high risk features are present.
Iron deficiency anaemia or other nutrient deficiencies
Gastrointestinal symptoms
Osteoporosis (thinning of the bones, which increases fracture risk)
Autoimmune disease (such as type 1 diabetes or autoimmune thyroid disease)
Weight Loss
Unexplained infertility or recurrent miscarriage
A family history of coeliac disease.
Dermatitis herpetiformis is the skin manifestation of coeliac disease which occurs as a rash that commonly occurs on the elbows, knees, shoulders, buttocks and face, with red, raised patches often with blisters.
How does Coeliac Disease Develop?
A person with Coeliac disease is born with the genetic material that will potentially develop into the disease. Only 1 in 30 people carrying these genes will eventually develop Coeliac disease. It is therefore believed that environmental factors also play a role in the development of the disease.
As coeliac disease has significant health implications, a definite diagnosis is paramount. The tests for coeliac disease are simple – just follow the steps.
Keep eating gluten
Do not commence a gluten free diet prior to being tested for coeliac disease. If a gluten free diet has already been adopted, the tests used to diagnose coeliac disease are unreliable.
Blood test are used for screening
Blood tests (coeliac serology) are used to screen for coeliac disease. Coeliac serology measures antibody levels in the blood, which are typically elevated in people with untreated coeliac disease.
A small bowel biopsy is essential
A diagnosis of coeliac disease can only be made by demonstrating the typical small bowel changes of coeliac disease (villous atrophy). This involves a gastroscopy (or endoscopy) in which several tiny samples (biopsies) of the small bowel are taken.
Once you are diagnosed
At the moment there is no cure for coeliac disease. It is a lifelong condition and following a strict gluten free diet is the only treatment. Once you have that medical diagnosis and gluten is removed from your diet, you should start to feel much better.
A gluten free diet allows the small bowel lining to heal, symptoms to resolve and reduces the long-term risk of complications.
There is no correlation between symptoms and bowel damage so even if you have no obvious symptoms; everybody with coeliac disease needs to adhere strictly to a gluten free diet.
Adjusting to the gluten free diet may seem difficult at first but with the help provided by Coeliac WA it will soon become easier and more manageable. Advice from a specialist dietition is invaluable and can greatly enhance the enjoyment to be had from a gluten free lifestyle.
Coeliac WA is a not-for-profit membership organisation committed to providing support, information and understanding to people diagnosed with coeliac disease, dermatitis herpetiformis or medically requiring a gluten free diet. Since 1979, Coeliac WA has been active in enhancing the quality of life for individuals requiring a gluten free diet in Western Australia. This has been achieved through Coeliac WA providing single, credible source of information and is the voice for people with coeliac disease.
Coeliac WA Contact Details
Street Address: Unit 2/ 4 Queen Street, Bentley WA 6102
Postal Address: PO Box 726, Bentley WA 6982
Phone: (08) 9451 9255
Toll free: 1300 458 836
Email: wa@coeliac.org.au
Website: http://wa.coeliac.org.au/
Remember a little bit of gluten does matter so read your labels carefully.If you would like further clarification about coeliac disease and your diet, it is wise to visit an Accredited Practising Dietitian (APD).
Flours that are suitable for gluten free bakin
Gluten Free Cereals
Cereal, breads and related products are important for energy, fibre, B vitamins and iron. The following options are gluten free;
• Rice porridge with rice bran or pysllium
• Gluten free muesli
• Gluten free packaged cereals eg cornflakes or rice flakes plus rice bran or
pysllium
• Gluten free breads – there are many options available at the supermarket
• Rice and rice noodles
• Gluten free pasta - combine with vegetables for increased fibre
• Quinoa – used in place of cous cous
Note: Oats
The safety of oats for consumption by a person with Coeliac disease is still questionable, despite extensive research. Although they contain gluten, oats actually contain gluten in a different for to that of wheat, rye and barley, and in much smaller proportions. Research shows that oats do bring about an immunological response in some people with Coeliac disease, however not all will react. Due to this, Coeliac Australia advise people with Coeliac to avoid oats in their diet. If someone wishes to challenge oats and determine their reaction, it should be done under the supervision of a doctor. Biopsy should be performed prior to the oat challenge and symptoms monitored afterwards. If symptoms occur, oats should be ceased immediately. If no symptoms occur, a second biopsy should be performed to check for any damage.
It is important to note that oats can often be contaminate with wheat/rye/barley during harvest and processing. Only oats that are certified ‘wheat contamination free’ should be consumed.
Vegetables and Legumes
Vegetables can be eaten cooked or raw. Vegetables are important sources of vitamins, minerals and fibre. Dark green ones are high in folate. Legumes are also important for protein, calcium, iron and vitamins.
Fruit
Fruit contains vitamins and fibre. It is a convenient and healthy gluten free snack.
Dairy
Dairy is important for calcium and protein. Try and have 2 to 3 serves from the milk group a day. If fat and cholesterol is a problem, then choose low fat dairy products.
Protein
Choose a variety of meat sources, including red meat, chicken, pork and fish. Red meat has 4 times the iron content of chicken or fish, so include it regularly. Animal protein gives haem-iron that is also more readily absorbed. Nuts and legumes will give complete protein when combined with other cereals and breads.
Added to site on : Friday, 14 February 2014