Going gluten-free has never been trendier – in fact, a recent survey found more than half of us have bought a ‘free-from’ product. But for many people, avoiding gluten isn’t just a lifestyle choice or a means of avoiding bloating, but a serious health matter. Gluten intolerance is a sign of coeliac disease.
Around 1 in 100 people in the UK are thought to be affected by coeliac disease. It causes painful and troublesome symptoms, as well as potentially serious damage to the small intestines as a result of consuming even the smallest amount of gluten.
And research suggests that around 500,000 people are living with the condition but yet to be diagnosed. Because the symptoms can overlap with other more common conditions, such as IBS and food intolerance/sensitivity, it can take a long time for coeliac disease to be accurately confirmed. Recent figures suggest the average length of time taken for someone to be diagnosed from the onset of symptoms is currently a staggering 13 years.
Here, Will Hawkins, a nutritionist explains more about coeliac disease, spotting the symptoms, and how the condition is managed…
What is coeliac disease?
While going gluten-free is a choice for some people, for people with coeliac disease it’s an absolute medical necessity.
Different from an allergy or intolerance, coeliac is classified as an autoimmune disease. This means the immune system accidentally mistakes an innocent substance for a threat and attacks healthy cells. “In this case, the innocent substance is gluten,” says Hawkins, “which is found in any food (or drink) that contains barley, wheat or rye.”
This internal reaction causes inflammation and damage to the surface of the small intestines, rendering it unable to absorb essential nutrients from food. It’s not entirely clear what causes the immune system to act in this way, but scientists believe it could be down to a combination of genetic and environment factors.
Autoimmune conditions can also sometimes, though not always, run in families. Studies show that for coeliac disease, if you have a close relative who has it, there’s a 1 in 10 chance you’ll develop it too.
What are the signs of coeliac disease?
It might sound unpleasant, but your stools might be the first warning sign. “As with a lot of digestive problems, the answer often lies in what you see in the toilet,” says Hawkins.
“Diarrhoea is the most common symptom of coeliac disease, while your poo may also be very greasy and smelly due to your body being unable to properly absorb the fat in your diet.”
Aside from unpleasant toilet trips, there are other painful signs that could give you a clue it’s coeliac disease. “You might also feel bloated, have a bad stomach ache, suffer from indigestion or feel nauseous,” says Hawkins. “Particularly after eating foods containing gluten.”
When people aren’t absorbing food properly, there can also be knock-on complications caused by a lack of certain vitamins and minerals. These include sudden and unexplained weight loss, low energy and fatigue, and conditions such as anaemia and osteoporosis.
How can you find out if you have it?
If you think you might be experiencing signs and symptoms of coeliac disease, the best thing to do is to speak to your GP. Remember, the symptoms could also be down to more common causes like IBS, but self-diagnosing is best avoided. You could be missing out on the chance to get an accurate diagnosis and important advice on managing your symptoms.
Routine testing for coeliac disease isn’t carried out on the NHS. However, after talking to you about your symptoms and medical history, and possibly examining you, there are tests your doctor can refer you for if they suspect you might have coeliac disease or another bowl problem that needs to be investigated. Blood tests can sometimes detect certain antibodies that are present in people with coeliac disease.
“You might be given a blood test to look for antibodies, or a biopsy to analyse your intestines,” says Hawkins. He stresses that you shouldn’t make any rash changes to your diet during this time.
“It’s really important that you continue to eat gluten products as you were before, in order for the doctor get accurate results from your tests. You should only stop eating gluten once you’ve been diagnosed.”
How can it be treated?
There’s no cure for coeliac disease, but the condition can be managed with a strict gluten-free diet. This isn’t just important for avoiding painful and distressing flare-ups, but to safeguard against long-term intestinal damage.
“The most effective treatment for coeliac disease is to simply stop consuming products that contain gluten,” says Hawkins. This might sound overwhelming, but Coeliak UK have a checklist of foods you should avoid, as well as tips and advice for anyone making the change.
Obvious sources of gluten include breads, pasta, cereals, cakes and biscuits. But gluten can also found in many common food items, such as fish fingers, sausages, gravies, sauces, stock cubes, soy sauce and even in some brands of chocolate.
If you’re unsure, Coeliac UK also has a free app called ‘Gluten Free Food Checker’ (available on iTunes and GooglePlay). The app can be really helpful when you’re out shopping in the supermarket. All you have to do is scan the barcode of a product and the app will tell you whether or not it’s suitable for you to eat.
“Make sure you check the ingredients on any food or drink you buy,” adds Hawkins. “If you’re eating at a restaurant, make sure the staff know about your condition so that they can recommend foods that won’t cause your symptoms to flare up.”
As an extra tip, Hawkins says you should look to incorporate more prebiotics and probiotics into your diet. He suggests green leafy veg and dairy products, as these help to promote good gut health.
Your doctor can also refer you to a specialist dietitian for support and practical advice to help you manage the condition day-to-day.
Of course, omitting gluten from your diet isn’t easy. However, it’s important for your health to try to avoid it completely as even small amount of gluten can damage your intestine. Thankfully, many supermarkets now offer gluten-free products. Restaurants are also beginning to adopt ‘GF’ annotations on menus to let coeliacs know which foods are suitable for them.
“If in doubt, make sure to ask,” says Hawkins. “It’s safer to enquire than eating something that could lead to days of discomfort.”
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