Celiac Disease and Gluten Free Dieting

The gluten free diet is a popular diet that can be extremely helpful for sufferers of celiac disease, dermatitis herpetiformis and non celiac gluten sensitivity to control their symptoms and have a happier and healthier gut. Below outlines what gluten is, the various conditions that a gluten free diet will help with and information on the diet.

What is Gluten

Gluten is the name given to proteins found within wheat and other grains such as barley and rye. Gluten is an important part for baking bread because it helps shape and provide elasticity to dough and helps with the rising process. The derived latin word “gluten” actually means “glue” because this is quite simply what gluten can be seen to do. Generally the two components of gluten are gliadin and glutenin - gliadin tends to be the component that is responsible for most of the negative health effects of gluten.

Celiac Disease

Celiac disease (also called coeliac disease) is an autoimmune disorder that causes the body to consider gluten as a foreign invader. This causes the immune system to attack the gluten and the area around it such as the lining of the gut. This damage causes nutrition deficiencies and digestive disorders.

Celiac Disease symptoms

Symptoms of celiac disease include:

• Digestive discomfort
• Digestive tissue damage
• Diarrhoea
• Gas and bloating
• Fatigue
• Anemia
• Vitamin K deficiency

Screening and Diagnosis

Celiac disease can be diagnosed by first undertaking a screening blood test that screens for celiac disease antibodies. This blood test requires you to consume gluten and the results can help suggest if you have celiac disease. To confirm the screening diagnosis a gut biopsy is then performed as an endoscopic biopsy. This procedure involves a camera passing through your throat and into your stomach and then gut. A small sample is taken and the sample is tested for damage to the gut lining. The little villi in the gut lining helps determine whether you have celiac disease by their appearance and length as well as an increased number of lymphocytes – small white blood cells.

Treatment

If you are diagnosed with celiac disease you will need to remove all sources of gluten from your diet. Only foods with a parts per million content of less than 20 can be consumed and these are termed gluten free foods. Gluten can show up in places you would not expect such as some medication, supplements and even some lip gloss. This diet will need to be adhered to lifelong as celiac disease is a chronic autoimmune disease and will not go away or get better without strict adherence to a gluten free diet. By avoiding gluten the gut can heal and symptoms reduce.

As the diet can cause deficiencies in some vitamins and minerals such as iron, calcium, vitamin D and magnesium supplements may be required. Gluten free multivitamins can be helpful to ensure adequate intake is undertaken. It may be advisable by your doctor to get a bone density test to ensure a lack of vitamins and minerals has not contributed to osteopenia or osteoporosis which is a thinning of the bones.

Dermatitis Herpetiformis

Dermatitis Herpetiformis, commonly referred to as DH is a skin condition that is closely linked to celiac disease. About 1 in 3300 suffer from DH whilst about 1 in 100 will have celiac disease. Like celiac disease, gliadin is the component of gluten that causes an intolerance leading to dermatitis herpetiformis. Gliadin can be found in wheat, barley and rye.

Dermatitis Herpetiformis Symptoms and Treatment

Whilst celiac disease causes intestinal disorders and discomfort, DH appears as itchy rashes and lesions on the body, commonly around the scalp, shoulders, elbows, knees and buttocks. Other problems associated with DH are thinning of tooth enamel, hair and skin abnormalities, heart problems and a fatty liver.

Dermatitis Herpetiformis can be treated with a strong antibiotic called dapsone but due the the chance of serious side effects such as liver problems, anemia and muscle weakness it is best to consider tackling the condition with diet changes. This means to consider a strict gluten free diet. See below for information on gluten free dieting. For more information about the disease including images and detailed information go to Derm Net NZ.

Non Celiac Gluten Sensitivity

This condition is defined as someone without celiac disease who has improvement in symptoms following a gluten free diet. Research is ongoing and it is not entirely clear what the causes are, some say it may be gluten and others say it could be a different ingredients such as FODMAPs found within wheat. There are no specific tests to confirm the condition.

If you feel like gluten is causing symptoms it is advisable to be screened for celiac disease first. Once celiac disease is ruled out then the next step is to discuss non celiac gluten sensitivity with your doctor. They may feel it is appropriate for you to follow a gluten free diet.

Gluten Free Diet

For suffers of celiac disease, dermatitis herpetiformis and non celiac gluten sensitivity avoiding gluten is strongly advised. There are many naturally gluten free foods as well as a lot of gluten free processed foods. The range in the supermarket has increased a lot in the past few years. There are also a lot of good substitutes for items such as flour and bread usually found within a “gluten free” aisle in the supermarket. Below is a selection of foods that have gluten and foods that are free from gluten. For a more indepth look at foods go to the gluten free food list page.

Common Gluten and Gluten free Food and Drinks

Where to Get Advice and Support

All of us with celiac disease find it trying at times and getting support can be extremely beneficial. Below are various organisations that you can find more information on celiac disease, DH or non celiac gluten sensitivity as well as finding support groups and latest research findings.

United Kingdom
Coeliac UK – https://www.coeliac.org.uk/

United States
Celiac Disease Foundation – https://celiac.org/

Australia
Coeliac Australia – http://www.coeliac.org.au/

New Zealand
Coeliac New Zealand – http://www.coeliac.org.nz/