What is Coeliac disease?
Coeliac disease is the permanent intestinal intolerance to dietary gluten. While this is a potentially serious disease if left untreated, the good news is that it can be managed very effectively by a change in diet.
When the disease is not diagnosed or treated, the lining of the small bowel is damaged. This causes the small finger-like projections, called villi that line the bowel, to flatten. Normal villi are responsible for breaking down and absorbing the nutrients from food. Where coeliac disease is present, the surface area of the bowel is depleted and this affects the absorption of nutrients, leading to problems such as deficiencies in vitamins, minerals, and sometimes, calcium, protein, carbohydrates, and fat.
Symptoms of Coeliac Disease
The symptoms of coeliac disease include:
- chronic indigestion
- gas
- bloating
- irritability
- vomiting
- loss of appetite
- fatigue
- lethargy
- depression
- weakness
- anaemia
- diarrhea
- constipation
- cramping
- nausea
- weight loss
Treatment for Coeliac Disease
The only effective treatment for coeliac disease is a change to a gluten free diet. In fact, it is essential that people with the disease do not eat gluten at all. However, while it may sound easy to eliminate gluten from your diet, it can actually be quite difficult as it is present in many things that you may not expect. Gluten can be found in:
- oats
- rye
- barley
- wheat
- buckwheat
- breads
- cereals
- pasta
- crackers
- commercial baked goods
- other processed foods
- gravies and sauces thickened with flour
- emulsifiers
- stabilisers
- hydrolysed vegetable protein
- malt
- ice cream
- desserts made from commercial mixes
- soups
- processed meats
- potato chips
- cakes and pies
- biscuits
- medications and vitamins that use gluten as a binding agent
- postage stamps
- lipstick
But this does not mean that you have to live according to a very restricted diet. There is now a wide range of gluten free products, including pastas, breads, and cereals, even beer. Of course, there is no problem with fresh meat, fish, or poultry, the majority of dairy products, fruit, vegetables, rice, potatoes, and gluten-free flours (such as rice or soy flour).
Once the sources of gluten have been removed from the diet, the inflammation in the intestine will begin to subside, usually within days. Complete healing and regrowth of the villi may take several months in younger people and as long as three years in older people. Once a gluten-free diet has been started as a treatment for coeliac disease, the person will need to remain on the diet for life. Any gluten, no matter how small the amount is, can damage the intestine.
When the gluten-free diet is first begun, it may be necessary to use supplementation in order to fix nutrient deficiencies, such as deficiencies in iron, folic acid, and fat soluble vitamins. Some people may also be advised to restrict the amount of lactose in their diet while they are symptomatic.
Most people on the gluten-free diet will make a complete recovery. However, a small percentage will not, as their intestines have been severely damaged. Therefore, if the diet isn't effective, they may need medication to control the inflammation in the intestines and other problems that result from the malabsorption of nutrients.
Originally published on Jul 23, 2008
