Worried about regularly bloating? Confused between gluten-intolerance and coeliac disease? Dietician Jo Travers explains all
With 1 in 100 people suffering from coeliac disease – and nearly half a million people not realising they have it – here’s a guide to what to look for and some tips for keeping it under control.
What is coeliac disease, and is there a cure?
Coeliac disease occurs when the immune system attacks the lining of the gut as a reaction to gluten. This is a protein found in wheat, barley, rye and, in small amounts, oats. The gluten triggers the immune system to produce antibodies, which then cause inflammation and damage the lining of the gut. There is no cure, although by completely avoiding gluten you can manage the condition and live symptom-free.
What are the symptoms of coeliac disease?
The most noticeable symptoms tend to be bloating, wind, diarrhoea and constipation, but these don’t necessarily mean you have coeliac disease! However, if you have these IBS-type symptoms, your GP should rule out coeliac disease before giving you a diagnosis of IBS.
Feeling more tired than usual can also be a symptom as your body stops absorbing iron. You may also suffer from weight loss and skin rashes – called dermatitis herpetiformis – that commonly develop on elbows, knees, shoulders or our face. If left untreated, coeliac disease may cause fertility problems, according to scientists at Nottingham University, so it’s always worth talking to your GP.
How is it different to gluten-intolerance?
Not everyone can tolerate gluten, but it doesn’t necessarily mean they have coeliac disease. Non-coeliac gluten sensitivity may cause similar symptoms, but ultimately it’s a different condition: the immune system doesn’t attack its own cells and the gut isn’t damaged. There is no clear understanding of why some people experience a sensitivity to gluten – scientists are on the case!
What causes coeliac disease – is it genetic?
There are some known risk factors, although the exact cause is not known. A family history of coeliac disease increases your risk from 1 in 100 to around 1 in 10 (which is still fairly low). People with coeliac disease have a set of genes that are different, but having these genes doesn’t necessarily mean you will definitely develop it.
People with type 1 diabetes, epilepsy, ulcerative colitis and Down’s syndrome also tend to have a higher risk of developing it, although the reason for this is not yet clear.
How can you manage the condition?
The only way to manage coeliac disease is by completely avoiding gluten. This includes foods such as cereals, bread, pasta, cakes, crackers and flour. Nowadays all pre-packaged foods must, by law, clearly label gluten-containing ingredients. There are strict laws covering the use of the label ‘gluten-free’.
Watch out for certain drinks. Many of us don’t realise that some barley squashes and beers contain gluten.
Even a crumb of toast can cause a reaction. If you share a kitchen, keeping utensils and cutting boards separate and using toaster bags can help to minimise the risk of cross contamination.
There are lots of naturally gluten-free foods – from rice and quinoa to nut flours and teff flour for baking. But you can also find a great range of gluten-free breads, pasta and more in supermarkets. The free-from market is now worth over £500 million in the UK!
Some gluten-free foods can be much more expensive than their gluten-containing equivalents. Speak to your GP about getting gluten-free foods on a prescription, to save a little money.
Can you use shampoo products that contain gluten?
Gluten is only a problem for people with coeliac disease if it’s eaten, so using a hair or skin product externally will not cause damage to the gut.
Where else can you go for advice?
For general advice and more information, visit Coeliac UK. If you think that you may have coeliac disease, go to your GP and get tested.
It pays to eat properly and look after your gut – read our tips on how to keep it happy.