What is Coeliac Disease?

Coeliac disease is a medical condition and is a permanent intestinal intolerance to dietary gluten (the protein portion of wheat, rye, barley, triticale and possibly oats). If left untreated, the lining of the small bowel (intestine) can be damaged. This causes a flattening of the tiny, finger-like projections, called villi, which line the inside of the bowel. The function of the cells on normal villi is to break down and absorb nutrients in food. In untreated coeliac disease, the lining of the intestine becomes inflamed and gives a characteristic flat appearance. The surface area, which enables the absorption of nutrients and minerals from food, is seriously depleted. This leads to deficiencies in vitamins, minerals and sometimes proteins, carbohydrates and fats. Around 10% of all first degree relatives (parents, siblings or children) with coeliac disease will also carry the disease.

Coeliac disease is more common than previously thought. While there are no current statistics in Australia, it is estimated to affect between 1 in 200 to 1 in 500 people (this would include undiagnosed cases). In the past, coeliac disease was regarded as only a childhood condition, which produced symptoms in very young children once gluten was introduced into their diet. It is now known that it can affect a person at any age from infancy to senior years. Many have few or no problems during childhood but develop symptoms only as adults. In addition, the symptoms of coeliac disease can be minor or atypical and can even be clinically silent.

Symptoms

The following symptoms may occur singularly or in combination:

  • Fatigue, weakness and lethargy.
  • Anaemia – that does not respond to treatment or recurs after treatment until the correct diagnosis is made and a gluten free diet is followed.
  • Flatulence and abdominal distention.
  • Diarrhoea – this may begin at any age and is often present for years prior to diagnosis.
  • Constipation – some are likely to experience constipation rather than diarrhoea.
  • Cramping and bloating.
  • Nausea and vomiting.
  • Weight loss – although many do not lose weight and some can even put on weight.

Since other conditions can closely mimic coeliac disease, the correct diagnosis can only be recognised if the bowel lining is damaged. This is done via a biopsy of the small intestine. A biopsy test should always be performed before starting a gluten free diet. Trialling a gluten free diet does not provide a diagnosis of coeliac disease and subsequent investigations whilst on a gluten free diet will render false negatives. This includes the serological testing (blood tests). Prior to diagnosis, a gluten free diet may delay the diagnosis of another condition with similar symptoms. It is important to discuss the possibility of coeliac disease with your doctor, particularly if you have a close relative with the condition or if they have been treated for anaemia on previous occasions.

Treatment

Those with coeliac disease remain sensitive to gluten throughout their life, so, in this sense, they are never completely cured — even if symptoms disappear, damage to the small bowel can still be taking place if gluten is being ingested. However, after the removal of gluten from the diet, a reversal of the abnormalities of the lining of the bowel occurs and the problem of deficiencies should eventually resolve. This usually takes a few months but in some cases can take up to a couple of years. Relapse can occur if gluten is reintroduced. Older patients often take longer to recover, however, people with coeliac disease should remain otherwise healthy as long as they adhere to the diet.

How can ORGRAN products assist?

ORGRAN produces a comprehensive range of gluten free products. These products can be enjoyed any time of the day and are suitable for people who are diagnosed with coeliac disease. Even more, you have the added benefit of knowing all ORGRAN products are free from the 8 most common food allergens. For those who suffer from IBS and other food intolerances, see our Tummy Friendly page.