Coeliac disease is considered neither an allergy nor intolerance. It is actually classed as an autoimmune disease, where the ingestion of gluten can have serious repercussions if the dietary requirements are not strictly followed. A complete exclusion of gluten from the diet is essential. In coeliac disease the immune system reacts abnormally to gluten causing the body to attack its own tissues and damaging the small bowel.
The small bowel is covered with finger like projections called villi. When gluten is ingested, the villi become inflamed and flattened over time.
The absence of villi decreases the surface area of the bowel and therefore limits the available area for nutrient absorption. If left untreated (gluten continues to be consumed), this can lead to malnutrition and other related complications, such as osteoporosis.
- Anaemia – iron or folic acid
- Nutrient deficiencies e.g. A, D, E, K & B12
- Fatigue, lethargy
- Irregular bowel motions (constipation, diarrhoea or alternating between the two)
- Bloating, abdominal pain
- Excessive gas
- Nausea and vomiting
- Weight loss
- Skin rashes such as dermatitis herpetiformis
- Easy bruising
- Bone and joint pain
- Low blood calcium levels
A blood test followed by a small bowel biopsy – this is the only way to retrieve a definitive diagnosis. Blood tests can return positive results but this does not always mean you have coeliac disease.
Lifelong exclusion of gluten. This will allow the small bowel to repair itself over time.
Intolerance can otherwise be described as a sensitivity of the body to particular foodstuff or chemical. In the case of gluten intolerance, a sufferer is unable to ingest gluten freely without discomfort or gastrointestinal disturbance but will not experience any serious repercussions. The difference is that gluten intolerance does not mediate an immune response by the body, therefore does not destroy the lining of the small bowel.
However, the symptoms of gluten intolerance are similar to those experienced from coeliac disease, with the exception of nutrient deficiencies.
- Abdominal pains
- Irregular bowel motions
- Bloating, excessive wind
- Fatigue/ lethargy
- Joint pain and aches
Ruling out coeliac disease as a cause and then assessing whether the exclusion of gluten from the diet alleviates symptoms.
Avoidance of gluten. The extent of avoidance will depend on the individual’s level of tolerance before they experience symptoms.
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This article was written by our dietitian Belinda Elwin who is a Dietitians Association of Australia member and Accredited Practising Dietitian and Nutritionist.
If you have any questions about nutrition related issues, you can make an appointment with Belinda today. We‘ll provide you with a simple and effective routine targeted to your concerns. Contact us today!