In the first part of this series I wrote about a number of things you need to keep in mind and change after being diagnosed. But first things first you need to understand what Coeliac Disease is, how it works, what it does.
CD is an autoimmune disease, not an intolerance or allergy, caused by the immune system’s reaction to prolamins (storage protein high in glutamine and proline) found in most common grains (wheat, barley, rye, etc.). The main characteristic of CD is small intestinal damage, damage and loss of absorptive villi that can lead to malabsorption.
Symptoms include a number of gastrointestinal problems and health issued related to malabsorption. Gastrointestinal symptoms include diarrhoea, abdominal pain and cramping. Due to the malabsorption a number of different issues can aries: vitamin K deficiency can lead to abnormal coagulation, calcium and magnesium deficiency can cause osteopenia and osteoporosis. Fatigue and weight loss might be caused by the inability to absorb carbohydrates and fats. Malabsorption of iron can lead to iron deficiency anaemia and megaloblastic anaemia might be caused by the lack of folic acid and vitamin B12.
Due to the high number of health issues linked to CD it’s really important to get diagnosed properly. CD is diagnosed with a blood test, the presence of antibodies can indicate CD, the diagnosis is confirmed by a biopsy where damage to the small intestine’s mucosa is investigated. If the diagnosis is confirmed further tests might be recommended to investigate the damage and CD related health issues.
Currently there is no other treatment than a 100% gluten free diet. Emphasis on diet. The immune system only reacts if gluten is ingested and digested. Adapting to the gluten free life can seem overwhelming at first but it’s not as difficult as it looks.
- start small, stick to naturally gluten free food at first
- make sure you avoid cross contamination
- learn how to read labels
- don’t panic, it’s not as complicated as it looks like
- don’t limit yourself to the free from isles in supermarkets and labelled gluten free food.
Since being diagnosed I came across a number of myths going around, here are a few that can be very confusing for “newbies”:
- gluten does not get absorbed through the skin, therefore you don’t need to worry about shower gels, shampoos and other cosmetics and skin care products.
- having CD does not automatically mean you have other intolerances and need to avoid anything other than gluten.
- meat, fish and eggs are gluten free regardless of what the animals are fed. the immune system reacts when gluten is digested and since the animals digest the gluten and it’s broken down into a few different proteins meat, fish and eggs are gluten free.
Since there is no cure for CD and the only way to avoid the symptoms and the damage cause by gluten is a completely gluten free diet it’s important to learn the basics and know what you’re up against. It’s not rocket science but it can be overwhelming at first.
Author: Emese Fayk
- Nature Medicine August 1997: Identification of tissue transglutaminase as the autoantigen of coeliac disease
- NHS UK