1. Coeliac disease is a rare condition
Over the past few years, it has become clear that Coeliac Disease is much more common than we used to think, it is one of the most common gastroenterological conditions in the world.
Recent research has shown that approximately one in 100 people in the UK have this condition, only 24% of these cases are actually diagnosed and that it is more prevalent amongst women than in men, with up to twice as many women affected.
It is known to occur more frequently in Caucasian populations in Europe and also in developing countries where wheat is a staple diet (the west of Ireland has the highest rate of the disease in the world).
2. Coeliac disease is a food allergy
Coeliac disease is not a food allergy or intolerance, it is an autoimmune disease where the immune system attacks your own tissues when you eat gluten. This damage your gut (small intestine) so you are unable to take in nutrients.
With a food allergy, the immune system overreacts to a particular food causing symptoms that are potentially serious or even life-threatening. In food allergic patients, symptoms begin shortly after ingestion of the food (a few minutes to an hour or so) and include hives, shortness of breath, light-headedness or vomiting.
3. Coeliac only affects the GI tract
Although typical symptoms of coeliac disease are GI related, now doctors are realizing that there is an array of other symptoms.
Non-classical CD and even asymptomatic CD patients can present a wide range of symptoms and signs, including anemia, vague abdominal symptoms (often similar to irritable bowel syndrome (IBS), neuropathy, ataxia, depression, short stature, osteomalacia and osteoporosis, liver disease adverse pregnancy outcomes and lymphoma to mention some.
4. Coeliac people can’t have dairy
While there may be some people who are both coeliac and lactose intolerant, this is not usually the case.
In untreated coeliac disease, the lining of the small intestine (microvilli) is damaged by the ingestion of gluten. The enzymes (lactase) on the tips of the villi are responsible for absorbing milk sugar (lactose). Until they heal, the enzymes are temporarily unable to do their job which can lead to symptoms of lactose intolerance, such as gas, bloating, loose stool or diarrhoea, and sometimes constipation.
However, some doctors with newly diagnosed patients, if they suspect there is an issue with lactose, they recommend a few months of a lactose-free or lactose reduced trial and the followed by a gradual rechallenge of the lactose-containing foods, as tolerated.
5. Gluten is an ingredient in wheat
Gluten is not an ingredient, it is the general term for a protein found in wheat (wheatberries, durum, emmer, semolina, spelt, farina, farro, graham, KAMUT khorasan wheat and einkorn), barley, rye and triticale - a cross between wheat and rye.
It comprises two major components: glutenins and gliadins, both of which and especially the former are toxic for celiac individuals.
6. Gluten is only found in food products
Gluten is found in a lot of unexpected places other than food including:
As there is no legislation requiring allergen labelling on them. Some additives used as a binder during drug manufacturing include gluten.
Lip glosses and shampoos might contain some ingredients with gluten that can be accidentally ingested and can cause problem for coeliac.
For some patient’s exposure to gluten ingredients may develop dermatitis herpetiformis, a related skin condition related to CD that causes itchy rashes.
Although some companies say their products do not contain gluten, they do not declare it as ‘Gluten Free’ as they cannot guarantee a risk of possible cross contamination during manufacturing
This is a very controversial point but it is better to consult your dentist.
7. Sauces and spice mixes are gluten free
Soy sauce, teriyaki sauce, gravy, salad dressings and marinades aren’t always gluten-free, usually wheat is used as thickener or used in the manufacturing process. This doesn’t mean you cannot consume them, there are GF brands available on the market these days.
Pre-packed spice mixes or “seasonings” a blend of spices and/or herbs, often combined with a carrier agent (e.g., salt, sugar, lactose, starches or flours) and an anti-caking agent.
Gluten-containing ingredients that are used in seasonings can include wheat flour, wheat starch, wheat crumbs or hydrolyzed wheat protein.
Use only natural spices and create mixes yourself!