What is Coeliac Disease?
Coeliac Disease is a life-long inflammatory condition of the gastrointestinal tract which affects people who are intolerant to gluten. Gluten is a protein found in wheat, barley, rye and possibly oats. Eating gluten-containing food has a damaging effect on the lining of the small intestine, thus greatly reducing the absorption of nutrients from food.
Does Coeliac affect both men and women of all ages?
The Coeliac disorder was once considered a rare condition of childhood. Doctors are now seeing the condition in both children and adults. The condition in adults is commonly diagnosed between the ages of 30 and 45, but more people are being diagnosed in later life.
Has the condition a tendency to run in families?
Research has established that there is a genetic link to Coeliac Disease. There is the possibility of one in ten relatives of a person with the condition that may also be affected, so family screening is recommended.
What are the common symptoms of Coeliac Disease?
Adults can experience a number of different symptoms including anaemia, diarrhoea, bloating, weight loss and fatigue. These symptoms can occur together or separately, and can be mild or severe. The symptoms can be characteristics of other medical conditions; therefore a gluten-free diet should not be adopted without first seeking medical advice.
Who and what can confirm Coeliac Disease?
Specific blood tests are available to help a doctor screen for Coeliac Disease. If positive, a referral to a gastro-enterologist (a doctor specialised in the system of the gut) for an endoscopy, is made. This will confirm whether or not the condition is present. It is important to be on a normal diet when carrying out these tests. It is also essential that anyone being tested for Coeliac Disease should not start a gluten free diet before diagnosis is confirmed. A normal diet for a minimum of six weeks is recommended to ensure accurate results and to receive the benefits of a proper medical diagnosis. *
* Food allergy tests alone cannot medically confirm the presence of Coeliac Disease.
What treatment is available?
There is no miracle cure as yet for Coeliac Disease. The only treatment is a gluten-free diet that needs to be maintained throughout life. It is not exactly clear how gluten damages the lining of the small intestine. However, with a gluten-free diet, the body absorbs nutrients as normal and the symptoms disappear. Although the benefits of the diet can be felt immediately, it can take several months before the small intestine recovers completely.
What information is available to help me make the right food choices?
After diagnosis you should be referred to a registered dietitian. The dietitian will provide you with practical advice on how to follow a gluten-free diet and assess your food intake to ensure you meet your nutritional needs, especially if other medical conditions exist with Coeliac Disease. In addition, the Coeliac Association Malta will provide you with the practical advice on the condition.
What is a gluten-free diet?
The main source of gluten in the diet is wheat flour, barley and rye, which are used in the manufacture of many foods including bread, pasta, confectionary foods like cakes, biscuits, pastry, etc.. Other possible sources of ‘hidden’ gluten are sauces, gravies and some processed foods Many naturally gluten-free foods such as rice, corn, soya, potatoes, pulses, meat, fish, eggs and fruit & vegetables, in their natural form, can be eaten freely. Special gluten-free products including ‘gluten-free flour, breads, crackers, pasta and many other items’ are also available on the market.
Research suggests that oats may be tolerated by some people with Coeliac Disease. However, products containing oats should not be included in a ‘gluten-free diet’ unless the product is certified to be gluten free.
Can a person with Coeliac Disease lead a healthy life?
A gluten-free diet does involve making some changes. To remain healthy and prevent complications, a ‘gluten-free diet’ has to be followed carefully for life. For some, just a small amount of gluten will cause an immediate symptom. For others, the odd indiscretion may not cause any obvious symptoms, but there would still have been some internal damage to the lining of the small intestine. People with untreated coeliac have an increased risk of developing osteoporosis and bowel cancer; however, studies show that following a well-balanced, strict ‘gluten-free diet’ with adequate calcium intake can reduce the risk.