Coeliac Disease

Coeliac (pronounced 'see-lee-ak') disease was not fully identified until 1950, even though the symptoms had been observed for many years. It is an intolerance to alpha-gliadin, a component of gluten, a protein that occurs in certain grains, particularly wheat. Gluten is valued in the baking business, as it helps dough to rise. However, up to 1% of the population can be intolerant of gluten, and its by-product, alpha-gliadin. Other grains containing gluten include rye, triticale (a hybrid of wheat and rye) barley and oats.

Gluten, in susceptible people, damages the intestinal villi which line the small intestine. Villi are responsible for the majority of absorption of nutrients from the diet. Damage to the villus (singular villi) will mean less nutrients are absorbed, particularly vitamins and minerals. Enzymes, like lactase, which live in the cells of the villi, will be inactivated. In the case of lactase, no lactose (milk sugar) will be able to be broken down, causing lactose intolerance. In addition, permeability across the intestinal wall is increased, meaning larger food fragments are able to pass through to the bloodstream, encouraging food allergies.

Within minutes of eating a food containing even the tiniest speck of gluten, a person with coeliac will experience severe abdominal cramps and usually diarrhoea.

Sydney nutritionist Bob Buist says that this gluten component is an intestinal irritant for all people, not just coeliacs. One in 15,000 Australians are fully fledged coeliacs, but thousands more have sub-clinical symptoms - closet coeliacs! Symptoms can include bloating, indigestion, constipation, flatulence, loss of appetite, anaemia, fatigue, lethargy and depression.

To test whether or not you are a fully certified coeliac, a sample of the inside of your intestine has to be taken for analysis. A blood test is also being developed, but is not as accurate as the intestinal biopsy.

For those who have 'sub clinical' coeliac disease, diagnosis is less clear-cut. The best way you can ascertain if gluten causes you problems is to eliminate it from your diet for about ten days. This will give the intestinal cells enough time to regrow. If your symptoms abate in this time, you may have a problem with gluten.

Why me?

Although true coeliac disease is hereditary, the sub-clinical variety probably comes as a result of years and years of gluten excess. It seems our society is addicted to gluten - everywhere you look there's bread, pasta, bagels, croissants, biscuits and cakes. Look closely at labels and you will find wheat flour (containing gluten) hidden in sauces, soups and a multitude of processed foods. Coeliac disease is diagnosed most commonly at infancy, as one would expect, after the introduction of grains to the diet. The other most commonly diagnosed time is for women in their 30s. The reason for this late-in-the-day occurrence in women could be due to stress acting as the last straw on a fragile immune system.

Those who were breast-fed as babies seem to have less risk of developing coeliac disease.

What to do

Avoid the grains containing gluten. Namely; wheat (this includes pasta, bread, pastries, semolina can cous cous) rye, barley and oats.
Gluten free foods include rice, rice products (rice cakes, rice noodles, risotto) Corn, corn products (polenta, tortillas, unsalted popped corn), potato, buckwheat, chick pea flour, quinoa, amaranth and millet. Avoid milk products, except for acidophilus yoghurt to improve intestinal microflora.

Useful Websites

The Coeliac Society of Australia Inc.

More Information

For more information, take a look through Help Yourself: an A-Z of natural cures for common complaints, by Mim Beim and Jan Castorina. It's published by Doubleday and is available through all good bookstores.

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