1. What is coeliac disease? 2. What are the symptoms of coeliac disease? 3. How can I test for coeliac disease? 4. How can a Nutritional Therapist help with coeliac disease? 5. What is gluten? 6. Which grains contain gluten? 7. If I am avoiding gluten, is there something I should be eating instead? 8. Where can I find gluten-free and wheat-free products? 9. Which alcoholic drinks contain gluten?
1. What is coeliac disease?
Coeliac disease is a permanent disorder caused by an abnormal immune response that is triggered by a protein called gluten, which is found in wheat, rye, barley and oats. The disease affects about one in a hundred people in the UK and is hereditary.
When a person with coeliac disease consumes gluten, the body responds as if the gluten was an antigen and it launches an immune-system attack which damages the villi (hair-like projections) that line small intestine. The villi are important to maximise efficient absorption of nutrients, so once damaged less nutrients can be taken up by the body which in the long term can lead to weight loss, iron and/or folate deficiencies, osteoporosis, and infertility, for example.
Symptoms are varied and may include stomach cramping, diarrhoea, distended abdomen, indigestion, offensive stools, nausea, depression, irritability, general tiredness, headaches, vomiting and joint and/or bone pain. Some people experience a red and itchy skin rash (dermatitis herpetiformis). Since symptoms are so varied, it can be a long time before coeliac disease is diagnosed.
The good news is that whilst there is no cure, coeliac disease can be controlled by avoiding foods containing gluten. Therefore, by keeping a close eye on your diet, most symptoms are likely be relieved.
2. What are the symptoms of coeliac disease?
Symptoms are varied and may include stomach cramping, diarrhoea, distended abdomen, indigestion, offensive stools, nausea, depression, irritability, general tiredness, constipation, vomiting, headaches and joint and/or bone pain.
Some people experience a red and itchy skin rash (dermatitis herpetiformis).
In the long term malabsorption can, for example lead to weight loss, iron and/or folate deficiencies, osteoporosis, delayed growth in children and infertility in adults.
Since symptoms are so varied, it can be a long time before coeliac disease is diagnosed.
If you suspect you have coeliac disease go and see your GP.
3. How can I test for coeliac disease?
You need to see your GP if you think you have coeliac disease. Symptoms for coeliac disease are similar to those of other diseases e.g. IBS (Irritable Bowel Disease).
Your GP may give you a blood test, but for a definitive diagnosis a biopsy of intestinal tissue will be carried out.
For those with coeliac disease, the blood tests may show anti-gliadin antibodies (IgA, IgG) and the biopsy of the intestinal tissue will show damaged villi in the intestinal lining.
4. How can a Nutritional Therapist help with coeliac disease?
A Nutritional Therapist will give someone with coeliac disease information on the disease and advice on how to best look after their health through diet and supplementation. With the aim of relieving all symptoms as quickly as possible.
Coeliacs need to avoid grains containing gluten i.e. wheat, rye, barley and oats but since these provide a good source of carbohydrate and nutrients, which in turn provide us with energy, it is important to find suitable options.
A nutritional therapist will advise on alternatives and also give information on which foods are gluten-free and how to find them in shops, super-markets and on-line. It can be challenging to start a gluten-free diet as gluten is found in many foods. Pasta, pastry, cereals, bread and processed foods, for example, may contain gluten Good alternatives include potato, rice, millet and corn.
It is important to check and read labels carefully. Gluten can be found in hydrolysed vegetable protein and malt, as well as gravies, beer, mustard and some binders and fillers.
As a Nutritionists, I will suggest you eat fresh vegetables, pulses, nuts, seeds, dried and fresh fruit as it is important for those with celiac disease to have plenty of fibre and to eat foods rich in iron and the B vitamins.
It is also important to chew foods carefully before swallowing as this will help your digestive system.
Good quality supplements providing nutrients to help compensate for the malabsorption caused by coeliac disease may also be recommended on an individual basis by a Nutritional Therapist, digestive enzymes are also something that I would recommend to help support your digestive system.
Tests can be carried out to check your nutritional status (your vitamin and mineral levels) as deficiencies can lead to serious health problems. E.g. a lack of iron can cause anaemia, a lack of vitamin B6 can contribute to depression.
If you would like an individual appointment, I will provide you with more detailed information tailored to your personal requirements, ensuring that your diet is well balanced and aiming to relieve your previous health concerns, for example, your energy levels may be restored and your digestive system healed.
I am NTC (Nutritional Therapy Council) Registered and a member of BANT (British Association of Nutritional Therapists).
5. What is gluten?
Gluten is the protein found in wheat, barley, rye and (to a lesser extent) in oats.
6. Which grains contain gluten?
Wheat, barley, rye and oats contain gluten.
Be careful that you check labels on packaged food as wheat flour is added to many sauces as well as being the main constituent of bread, pasta, cakes, biscuits and pastry.
Avoid Semolina as this comes from the outer coat of wheat (and is therefore not gluten-free). Avoid Couscous as this is semolina, rolled and coated with wheat flour. Avoid Bulghur wheat as it is wheat that has been soaked, cooked, dried and cracked. Avoid Spelt wheat as this is wheat, even though the gluten content is less than in other types of wheat.
7. If I am avoiding gluten, is there something I should be eating instead?
Yes, you need to be eating good quality carbohydrates and if you are avoiding gluten, then alternatives include potato, rice, millet, quinoa, buckwheat (a herb), polenta, soya and corn/maize.
These are often made into flour as well, which can be used to cook with (instead of wheat flour). There are many recipe books available to help inspire you to cook and nearly all supermarkets have a ‘Free From’ or ‘Gluten-Free’ section and their websites offer further help and information.
Gram flour and urd flour (from pulses) are gluten-free and can also be used instead of wheat flour, although for first-time users, I suggest following a recipe.
8. Where can I find gluten-free and wheat-free products?
Nearly all supermarkets have a ‘Free From’ or ‘Gluten-Free’ section and their websites offer further help and information. They usually stock several types of gluten-free breads, flour, cakes, biscuits, pastas, sausages and breakfast cereals.
The UK Coeliac Society publishes a yearly updated list of gluten-free foods.
Many foods are naturally gluten-free such as fish, meat, cheese, milk, eggs, fruit and vegetables.
Some foods are made gluten-free by the removal of gluten from wheat flour, to produce wheat starch, however, a small number of coeliacs consuming these products will still present with their symptoms. For this minority, it is suggested that the naturally gluten-free foods (wheat-free) are selected.
9. Which alcoholic drinks contain gluten?
Beer/lager may contain small amounts of gluten where wheat is used in brewing. Spirits (where wheat is used) are gluten-free as all traces of gluten are removed during distillation.