What is Coeliac Disease?
People with coeliac disease cannot tolerate a protein called gluten. When they eat gluten their immune system responds by damaging the small intestine. .
The most typical symptoms of coeliac disease are gut problems such as diarrhoea, bloating and abdominal pain, which are caused when the body’s immune response damages the gut lining. This damage often triggers fatigue and anaemia if important nutrients from food are not absorbed sufficiently as a result.
The discovery of the cause of coeliac disease may also be partly attributed to the Dutch famine. With wheat in very short supply there was an improvement at a children’s ward of coeliac patients. Stories tell of the first precious supplies of bread being given specifically to the (no longer) sick children, prompting an immediate relapse. Thus in the 1940s the Dutch paediatrician Dr. Willem Dicke was able to corroborate his previously researched hypothesis that wheat intake was aggravating coeliac disease. Later Dicke went on to prove his theory.
if you suspect you have coeliac disease or a problem with wheat, don’t stop eating gluten. First, visit the Coeliac UK website and fill in their assessment questionnaire. Then go to your doctor and ask for a blood test.
Coeliac disease is genetic and runs in families. A genetic test can be done using a sample of blood or cells taken from your mouth by swabbing the inside of your cheek. However, this test can suggest that you may have a diagnosis of coeliac disease, but they it confirm a diagnosis. Up to a third of the population carry these genes, although only a small subset – 2 to 3% — of all people with these genes will ever get coeliac disease.
What this test can tell you is whether you are at risk of having celiac disease, since without these genes it is virtually impossible to get celiac disease. This is one celiac disease test that only needs to be checked once in a lifetime, since our genetic makeup does not change.
The only definitive way to diagnose the condition is to have a biopsy. A sample of tissue from the lining of the small intestine is taken. The procedure takes just 10 to 15 minutes.
There is also an antibody test that can be done. They can be negative when first checked but become positive later in life when coeliac disease starts to develop. For more info, check out “Confirming a Diagnosis of Celiac Disease.”
The condition affects about one in 100 people in the UK, but according to the charity Coeliac UK, only 24 per cent of those with the condition have actually been diagnosed. This means there could be as many as half-a-million people who have coeliac disease, but don’t yet know they’ve got it.
JFK is thought likely to have had coeliac disease, although a diagnosis was never made in his lifetime. Kennedy’s Irish heritage, long duration of gastrointestinal complaints (since childhood), diagnosis of irritable bowel syndrome and migraine, presence of severe osteoporosis, and the development of Addison’s disease all lead to a presumptive diagnosis of coeliac disease.
There is no cure for coeliac disease, however it can be effectively controlled by diet alone, therefore it is essential that those affected know what they can and cannot eat. So if a person is diagnosed, what exactly can they include in their diet?
Many foods are naturally gluten-free, such as unprocessed fruit, vegetables, milk, eggs, rice, fish and meat (except sausage meat). The main foods to be avoided include bread, cakes, biscuits, pizza, pasta, spaghetti, as well as certain soups, sauces, gravies and breakfast cereals.
Making the adjustment to a gluten-free diet is not always easy. According to Dr. Peter Green, Director Celiac Disease Center at Columbia University:.
“I think there’s a lot of difficulty when people get diagnosed. They can get anxious – and angry and get depressed. It’s a pretty big deal because you have to learn what not to eat but also what to eat”
It is thought that the prevalence of coeliac disease is particularly high in Ireland. According to Dr. Peter Green:
“Celiac disease was formerly considered a rare disease of childhood. It is now recognized as being very common in those of European descent, one of the most common genetically determined conditions physicians will encounter. Recent studies have demonstrated the country with the greatest prevalence to be Ireland”.
Why Ireland may have an increased prevalence towards coeliac disease is only now becoming understood. From prehistory until relatively recently, the Irish diet has been very low in gluten. This allowed gluten-intolerant genetic traits to persist.
The first farmers arrived in Ireland 6,000 years ago, and the milk products became central to the Irish diet. Although cereal was eaten, it was largely in the form of oats, which were the only cereal eaten by Irish people before the famine. It was only after the famine that wheat became prevalent in Ireland, and those with coeliac disease have been suffering ever since!
PS: Looking for some gluten free breakfast ideas? Check out our award winning gluten free muesli, (which is registered with Coeliac UK), also worth taking a look at our gluten free cereal bars, our gluten free porridge oats and our gluten free porridge bread mix.