#coeliacawarenessweek what you need to know!

It may be a staple in the Western diet but gluten can cause serious health complications for many people. The most serious immune reaction to gluten, coeliac disease, affects one in 100 people, most of who don’t know they have it.

Coeliac disease is an autoimmune disease triggered by the ingestion of gluten (found in wheat, barley and rye) in genetically susceptible individuals. It is one of the most chronic digestive disorders worldwide and can affect children and adults alike. For those with CD, gluten sets off an autoimmune reaction that can eventually lead to complete destruction of the villi, the tiny finger like projections lining the small intestine. For those diagnosed with coeliac disease it is essential to follow a gluten free diet for life.

The Many Faces Of Coeliac Disease

Healthy villi are vital to the proper digestion and absorption of food. People with coeliac disease produce antibodies that, in combination with hormone-like substances called cytokines and the direct effect of immune cells, attack the intestine and flatten the villi, leading to malabsorption and illness. Because villi allow the small intestine to absorb nutrients from food, people with coeliac disease may easily become malnourished and low in certain vitamins and minerals. This autoimmune response is the main difference between gluten sensitivity and coeliac disease.

A review paper in The New England Journal of Medicine listed 55 “conditions” that can be caused by eating gluten. These include osteoporosis, irritable bowel disease, inflammatory bowel disease, anaemia, cancer, fatigue, canker sores, and rheumatoid arthritis, lupus, multiple sclerosis, and many other autoimmune diseases. Gluten is also linked to many psychiatric and neurological diseases, including anxiety, depression, schizophrenia, dementia,  migraines, epilepsy, and neuropathy (nerve damage).

We used to think that gluten problems or coeliac disease were confined to those who had digestive symptoms. However the truth is that gluten can affect any body system

The classic digestive symptoms of coeliac disease include abdominal pain or discomfort, constipation, diarrhoea and bloating, which is one of the reasons it is often misdiagnosed for conditions such as Irritable Bowel Syndrome (IBS). However many people with coeliac disease will not show any gut symptoms at all.

The diverse range of symptoms makes it difficult to get a diagnosis.  If you suspect gluten is a problem it is important to get tested via your GP or health care practitioner before removing gluten from your diet.

Common Symptoms Associated With Coeliac Disease

Digestive symptoms – abdominal pain, constipation, diarrhoea, bloating, wind, nausea and vomiting

Unexplained weight loss

Infertility, still birth, poor foetal growth, miscarriage

Autoimmune conditions e.g thyroiditis, diabetes type 1, rheumatoid arthritis, autoimmune hepatitis, sarcoidosis, alopecia areata (hair loss)

Menstrual irregularities, delayed menarche, loss of periods, early menopause

Migraines, foggy head, poor concentration

Osteoporosis, osteopenia, bone and joint pain

Dermatitis herpetiformis

Chronic fatigue

Abnormal liver function

Depression and mental health issues

Neurological issues such as ataxia (poor muscle coordination), migraines and neuropathy (numbness and tingling in the hands and feet)

Vitamin and Mineral deficiencies, Iron deficiency anaemia

Mouth ulcers, glossitis, Dental enamel defects

How Common is Coeliac Disease?

Coeliac disease has an overall prevalence worldwide of 1 % with large variations between countries. If you have a family member with coeliac disease your risk of developing the disease is greater (8–15 %). Other at risk groups are people with other autoimmune or genetic diseases like Type 1 diabetes mellitus, Addison’s disease, Hashimoto’s thyroiditis, IgA deficiency and a skin condition known as dermatitis herpetiformis.

CD appears to be increasing, particularly over the last 2-3 decades. One study comparing the blood of 10,000 people from 50 years ago to 10,000 people today found that the incidences of full-blown coeliac disease increased by 400 percent during that time period.

However many people still remain undiagnosed. A recent study in the UK demonstrated the diagnosis of those with CD has increased fourfold over the past two decades yet three quarters of sufferers remain undiagnosed.  So if you think gluten may be affecting your health seek professional advice and testing.

 

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