- Celiac disease is not a food allergy or an intolerance but an autoimmune disease caused by a reaction to gluten.
- Damage to the gut lining occurs when someone with celiac disease eats gluten.
- Celiac disease affects at least 1 in 100 people in the UK and in Europe; however, only about 24% of people with the condition are currently clinically diagnosed.
- The average length of time taken for someone to be diagnosed with the disease from the onset of symptoms is a staggering 13 years.
- There is no cure for the condition; the only treatment is a strict gluten free diet for life.
- If a gluten free diet is not followed, the disease can lead to nutritional deficiencies and other complications such as osteoporosis, cancer of the small bowel and unexplained infertility problems.
- Gluten is a protein found in the grains wheat, rye and barley. Some people with celiac disease are also sensitive to oats.
- Obvious sources of gluten include foods that contain traditional flour such as, breads, pasta, cereals, cakes and biscuits. Gluten is also found in many favourite foods such as fish fingers, sausages, gravies, sauces, stock cubes, soy sauce and even in some chocolate.
- If someone with celiac disease accidentally eats gluten, they are likely to be unwell within a few hours. Symptoms can be varied but include severe diarrhoea and vomiting and can last several days.
- Gluten free food can be contaminated by food that contains gluten during preparation. Sources of contamination include breadcrumbs in toasters and on bread boards, utensils used for spreading and spooning jam, butter, chutney etc onto bread and from cooking oil and water.
- It is a myth that you can grow out of celiac disease. Once you are diagnosed, you have it for life.
- Celiac disease is a genetic condition and runs in families. Studies show that if someone in a family has the condition, there is a 1 in 10 chance of a close relative developing the disease.
- 1 in 4 people with celiac disease have previously been treated for Irritable Bowel Syndrome (IBS) prior to diagnosis of celiac disease, so people with IBS should be tested for celiac disease.
- Dermatitis herpetiformis (DH) is the skin presentation of celiac disease.
Symptoms of celiac disease range from mild to severe and can vary in individuals
- recurrent stomach pain, cramp, bloating, diarrhoea, nausea, excessive wind, constipation
- chronic fatigue/fibromyalgia
- mouth ulcers
- skin rashes including eczema, psoriasis, acne
- neurological problems – ataxia (poor balance) and peripheral neuropathy (numbness or tingling in the hands and feet)
- Dermatitis herepetiformis (red patches on the skin that are raised, itchy, burn and blister)
- Most other autoimmune disease eg hashimoto’s, rheumatoid arthritis, multiple sclerosis, lupus
WHAT IS THE PROBLEM WITH GLUTEN?
Modern day gluten is not the same gluten that our grandparents ate. In order to create bread and pastries that are fluffier and softer, scientists developed hybrid strains of wheat that contains an entirely new form of gluten not found in the original plants. This modified gluten causes the damage to the gut that can lead to the wide variety of symptoms and diseases listed above. The New England Journal of Medicine has listed fifty-five diseases associated with gluten (Farrell RJ, Kelly CP. Celiac sprue. N Engl J Med. 2002 Jan 17;346(3):180-8. Review).
Even if you do not have celiac disease or other autoimmune disorders, it may still be harmful to eat gluten. Non-celiac gluten sensitivity is something that is now being recognised as a problem in many countries across the world although further research is needed to fully understand this condition.
Testing for celiac disease is carried out initially by a health care provider who will do a blood test to screen for celiac disease antibodies. A gastroenterologist, may carry out an outpatient procedure where an endoscopic biopsy is taken of the small intestine and is analysed to see if there is any damage consistent with celiac disease.
Diagnosis of celiac disease or non-celiac gluten sensitivity can also be identified by completely eliminating gluten from the diet for up to three weeks and seeing if there are any significant improvement of symptoms. Re-introduction of gluten after a three-week period or longer may then result in a return of symptoms.