Coeliac disease is an autoimmune disorder which affects a person’s ability to digest the main protein found in gluten called gliadin. This protein is mistaken as an invader and the body starts to attack the lining of the small intestine in a bid to rid the body of the foreign object.
This sets off an inflammatory reaction which causes damage and flattening to the finger-like projections or villi which line the intestine. These villi are very important for the surface area of the intestine and particularly aid effective nutrient absorption. The damaged villi can repair themselves when gluten is completely avoided; however, it takes time and proper nutritional support to achieve this.
Coeliac disease is an autoimmune disorder and the potential for its development can be genetically inherited, but it is ultimately triggered by an event, e.g. high stress from a life event or an acute infection. Genes play a role in susceptibility, but ultimately these genes need to ‘switched on’ (epigenetics) in order for disease state to arise.
Due to the pathology of coeliac disease, nutrient absorption is a key priority, especially B vitamins and minerals such as iron and calcium. As well as avoiding all gluten-containing foods, cross-contamination is a huge issue. Preparing and cooking food separately is a must. Even one single crumb can trigger a reaction! So double checking when eating out is not fussy, it’s a necessity.
When a coeliac ingests gluten, the reaction can be immediate, delayed, severe or mild to moderate. They can vary from projectile vomiting to stabbing and churning pains in the intestinal area, nausea, brain fog, fatigue, itching and so on. Not everyone is the same.
Someone with coeliac disease may experience several different symptoms that can mimic other disorders, which is why it often takes a long time to reach a diagnosis.
Common symptoms
- Fatigue
- Skin rashes
- Dermatisis herpetiformis
- Nausea
- Foul-smelling wind and stools
- Bloating
- Abdominal pain
- Diarrhoea or constipation
- Anaemia
- Mouth ulcers
- Cognitive impairment
Headaches
Excluding gluten in the diet
Coeliac disease can be managed through the complete exclusion of gluten. Gluten is found in wheat, rye, barley and other grains. Many people miss bread, pasta, and wheat-based products when they are diagnosed. Avoiding gluten can be daunting as it is often hidden in products you wouldn’t expect. You’ll soon become a label reading ninja!
Gluten-free alternatives include:
- Flours including corn, potato, rice, chickpea, buckwheat, amaranth, quinoa, teff, almond, cashew and tiger nut
- Pasta made from corn, rice, quinoa, peas, chickpeas or lentils
Top tips on where to start with managing coeliac disease:
- Cook from scratch as often as possible so you know what’s going into your food
- Stick whole foods – fruit and vegetables and gluten-free grains if tolerated, beans, pulses, nuts, good quality meat, fish, seeds
- Avoid processed foods
- Become a label reading expert – gluten is hidden in a lot of products you wouldn’t expect
- Be careful when eating out and don’t be afraid to ring ahead or ask about cross-contamination procedures
- Work with a practitioner who can help to optimise gut health and help to restore nutrient absorption and correct and deficiencies
- Focus on stress reduction by meditating, journaling, counselling, exercise
- Although coeliac disease cannot be reversed, if you can identify the trigger that leads to its development you can work on healing the root cause (e.g. high stress, an infection or virus)
- Relax around food as much as possible, risk of gluten contamination is scary at first but you’ll find your flow with it
Thanks to Beth Raven from Positive Plate Nutrition.
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