Coeliac disease is a life-long autoimmune disease caused by an intolerance to gluten, which is a protein found in wheat, barley and rye.
The National Institute of Health and Care Excellence (NICE) estimate that there are currently 600,000 people in the UK with coeliac disease, but currently only 10-15% of these actually have a medical diagnosis.
With key symptoms such as migraines, mood swings, fatigue, hair loss and lots of gastro-intestinal problems, the effects have a profound impact on an individual's lifestyle.
Once diagnosed with coeliac disease there is only one form of treatment - adopting a gluten-free diet for life.
We spoke to Norma McGough, director of Policy, Research and Campaigns at Coeliac UK charity to find out more.
What are the symptoms of coeliac disease?
“The symptoms of coeliac disease range from mild to severe, and include a range of gut related symptoms that include bloating, diarrhoea, nausea, excessive wind, constipation, tiredness, headaches, mouth ulcers, sudden weight loss and also anaemia."
What should you do if you recognise these symptoms?
"If you have any of these you should ask your GP for a blood test which will test for antibodies that are produced in those people with coeliac disease in response to eating gluten – so you must also be on a normal gluten-containing diet at the time of testing.
"The next step is referral to a gastroenterologist to have endoscopy with biopsy to confirm diagnosis by recognising the typical damage in the lining of the gut.
" It is essential, that people do not remove gluten from their diet for a minimum of six weeks before both tests have been done as this could lead to false negative results.”
Once diagnosed, how can coeliacs adopt a gluten-free diet?
“Gluten is found in the cereals wheat, barley and rye and a minority of people with coeliac disease also need to avoid gluten-free oat products.
"You can eat any naturally gluten-free foods, such as meat, fish, fruit and vegetables, rice, potatoes and lentils and also processed foods which don’t contain gluten such as some ready meals and soups – but make sure you check the labels to see there are no gluten-containing ingredients.
"Coeliac UK, the national charity for people with coeliac disease, produces a yearly Food and Drink Directory which lists in the region of 10,000 foods that can be included on a gluten-free diet.”
“In addition you can buy gluten-free substitute foods (foods made from flour) in stores such as specially made gluten-free bread, flour, pasta, crackers and biscuits. If you are medically diagnosed with coeliac disease you will be able to get some staple gluten-free food on NHS prescription.”
Are there any surprising foods which contain gluten?
“There are many myths or misinformation out there regarding what is and isn’t gluten-free which include the notion that the grain spelt is gluten-free – which is not correct - spelt is an ancient strain of wheat and contains gluten and is not suitable for people with coeliac disease whilst yeast is naturally gluten-free.
"There is a risk of contamination for some yeast extracts though so it’s important to check the label for ‘may contain’ statements. Beer, lagers, stouts and ales all contain varying amounts of gluten and are not suitable if you have coeliac disease however specially manufactured gluten-free beers are available and are listed in the Food and Drink Directory. However, you do not have to go without a drink as cider, wine, sherry, spirits, port and liqueurs are all gluten-free.”
“In addition to the list of gluten-free foods mentioned previously, cereals that don’t contain gluten include rice, buckwheat, millet, sorghum, quinoa, teff and corn (maize). Whilst vegetables that are also gluten-free include potatoes, sweet potatoes, yams, plantains, cassava (manioc) used to make tapioca and amaranth that may also be used as a cereal substitute.”
Does the gluten-free diet help with weight loss?
“The gluten-free diet is not necessarily beneficial in terms of weight loss as losing weight requires achieving a greater calorie usage than intake. If you eliminate groups of foods and don’t replace the equivalent calories you may achieve a negative calorie balance but there’s nothing intrinsic about the gluten-free diet relating to weight loss.”
Are there any other myths about going gluten-free that you'd like to debunk?
“Myths about going gluten-free that currently prevail are centred round the use of the gluten-free diet for conditions other than coeliac disease.
"There are some studies that indicate that some individuals have similar symptoms to people with coeliac disease that improve following a gluten-free diet but that do not have the usual markers of coeliac disease i.e. typical antibodies, genetic make-up or damage to the lining of the gut. There is currently ongoing debate about this but agreement that manifestations of coeliac disease can be varied. We await the further research to substantiate these debates.”
For more information about coeliac disease and non-coeliac gluten sensitivity visit www.coeliac.org.uk or call their helpline on 0845 305 2060.