What is coeliac disease?

Coeliac disease (CD) is a condition affecting the small bowel, damaging the lining and preventing absorption of food nutrients.

CD affects about one percent or one in every hundred people.  An immune reaction to gluten (proteins in wheat, rye, barley, triticale and oats) is responsible for the inflammation and damage to the small bowel.

Symptoms of CD may include:

  • Weight loss
  • Diarrhoea
  • Abdominal pain
  • Anaemia.

When the small bowel is damaged, nutrients from our food aren’t absorbed properly into the body. Fortunately, avoiding these grains means the immune reaction stops, the small bowel heals, and symptoms improve.

Very small amounts of gluten can cause damage to the intestine, with or without obvious symptoms. People with CD must avoid gluten for the rest of their lives.

Since removing gluten causes the bowel to heal, it is important that you do not trial a gluten-free diet before you are tested, because the test results will not be accurate. To correctly diagnose CD you must eat the equivalent gluten content of four slices of bread each day (for adults), for four to six weeks before testing.

A screening blood test with your GP can show whether or not coeliac disease is likely to be present, but a small bowel biopsy performed by a Gastroenterologist is necessary to accurately diagnose coeliac disease.

Gluten is found in large amounts in:

  • Wheat (spelt, durum, atta)
  • Rye
  • Triticale
  • Barley.

And in small amounts in:

  • Oats
  • Ingredients made from the above grains e.g. malted barley, wheat starch, maltodextrin.

The above grains need to be replaced with gluten-free grains such as:

  • Soy
  • Buckwheat
  • Rice
  • Sorghum
  • Maize/corn
  • Amaranth
  • Millet.

Nuts, seeds, legumes, meat, fish, milk, cheese, fruit and vegetables are all gluten-free in their whole form.

Choosing the right foods and making sure that your diet is well-balanced can be difficult without professional help. It is essential that people with CD understand where gluten can be found in foods and what to look for on a food label.

It’s especially important for young children diagnosed with CD to see a health professional, since problems with nutrient absorption can affect their growth and development.

Without a properly maintained gluten free diet, people with CD are at greater risk of osteoporosis, and due to the inflammation within the bowel, higher rates of cancer are also common. A repeat small bowel biopsy is needed when people are symptom free and then throughout life.

An Accredited Practising Dietitian (APD) can help you to identify the different types of foods to include and avoid whilst still allowing you to enjoy a varied and nutritious diet.