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Coeliac Disease - When Gluten-Free Is Not a Choice

Coeliac disease is an autoimmune reaction triggered by the consumption of gluten, a protein found in wheat, rye and barley. This autoimmune disease however, does not only affect our digestion and small intestine but may trigger autoimmune reactions in various other tissues and organs, causing a wide range of physical and mental health issues.



What is Coeliac (celiac) disease?


Coeliac disease is an autoimmune reaction triggered by the consumption of gluten, a protein found in wheat, rye and barley. If a person with celiac disease gets exposed to gluten (mainly the gliadin peptide, one of the proteins making up gluten), the immune system gives an abnormal reaction and starts attacking the lining of the small intestine and as a result, damages the villi-rich mucosa. The damaged villi make it very hard for the body to absorb nutrients, easily leading to malnutrition. This autoimmune disease however, does not only affect our digestion and small intestine – according to our current understanding, coeliac disease may trigger autoimmune reactions in various other tissues and organs, causing a wide range of physical and mental health issues.

 

How is it diagnosed?


Interestingly, coeliac disease can remain hidden and asymptomatic, but it’s important to note that the lack of digestive issues does not rule it out, as CD can affect so many areas of the body. It is also quite hard to get an accurate diagnosis, as the medical community is not yet entirely clear on what is causing it and all the potential effects on the body, as it can mimic so many other digestive disorders (such as IBS). Currently, the diagnosis takes into account the combination of medical history, symptoms, blood tests and genetics, as coeliac disease can commonly run within families. The presence of other autoimmune disorders can also indicate a higher risk (e.g. lupus, thyroid disease, rheumatoid arthritis, type 1 diabetes).

 

Signs & Symptoms


Symptoms of coeliac disease are very diverse and highly dependent on the individual. The most typical are: abdominal pain, bloating or gas, diarrhoea or constipation, nausea and vomiting, vitamin and mineral deficiencies, unexplained weight loss, fatigue, headaches, skin rashes, osteoporosis, joint, muscle or bone pain, infertility or miscarriages, depression or anxiety, sores and ulcers in the mouth, skin rashes, neuropathy, hair loss.

 

Living with Coeliac Disease


In most cases, cutting out gluten completely eases symptoms and helps to heal the damaged walls in the small intestine. This is crucial, as at the moment, there is no pharmaceutical treatment that would resolve it completely, therefore to stop any further damage and begin the healing process and restoration of healthy digestion, it is a must to stop eating all foods containing gluten. If left untreated, there are serious health risks that can develop, for example heart disease, lymphoma, small bowel cancer, diabetes, multiple sclerosis, anaemia, malnutrition, infertility and various mental health conditions (depression, schizophrenia), to name a few.

Luckily, most food groups are naturally gluten-free (in their unprocessed forms), such as: fruits, vegetables, clean cuts of meat and poultry, seafood and fish, dairy, beans, legumes, seeds and nuts.


Foods to avoid: wheat, barley, rye (e.g. cereals, bread, pasta), couscous, durum, bulgur, semolina, spelt, graham flour, farina, triticale


Foods to avoid unless labelled gluten-free: beer, bread, processed sweets (candy, cakes, cookies etc), snacks (crackers, crisps), sauces and salad dressings, pre-packaged processed foods (lunch meat, hot dogs etc), vegetable cubes, gravy, soy sauces, starch (mixture or vegetable, gelatinized or modified), cereal extract, bran


Gluten-free grains and starches: arrowroot, amaranth, rice (brown is best), buckwheat, quinoa, corn, cornstarch, tapioca, millet, flour from almond, chickpeas, coconut, potato and pea, psyllium husks, oats (but best to make sure it is labelled gluten-free)



If you are interested in learning more about Coeliac disease and dietary guidelines, have a look at this comprehensive overview:

Coeliac_disease_Nikolett_Virag
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