Coeliac Disease, Gluten Free and Wheat Free Eating - Understanding the Disease

Let's start by explaining gluten.

Gluten is a protein present in many cereals such as wheat and their derivatives such as wheat flour and all the preparations that contain wheat or wheat starch (100 ppm gluten), such as small goods, hamburgers, pasta, pastry, pizza, batter, shortbread, cake, bread, biscuits, toast, rusks and which may include various forms of confectionary and medications.

Other cereals including rye (secalin), barley (ordein), oats (avein), corn (zein), triticale, and spelt and their derivatives also contain gluten.

Some sources of gluten are obvious whereas others may be hidden or not so obvious. For example, consider the following basic foods.

Malt and malt vinegars derived from wheat and/or barley should be avoided. Caramel colouring derived from or containing wheat may contain gluten and should be avoided if the source is unknown. "Strongbow" Ciders are not acceptable in a gluten free diet for this reason whereas "Mercury" Ciders are.

Some Soy, Tamari and other Sauces may contain wheat and gluten.

Boiled glucose lollies are often coated in wheat starch to prevent them from sticking together and converting them from gluten free to a non acceptable dietary inclusion.

Substances present in the gluten - prolamine and gliadin- are responsible for the reaction in the body that causes poor intestinal absorption of all nutrients from food intake.

Upon exposure to these proteins the enzyme tissue transglutaminase modifies the protein, and the immune system cross-reacts with the bowel tissue, causing an inflammatory reaction.

The intolerance to gluten, commonly known as Coeliac (Celiac) Disease, affects more than 250,000 Australians, and possibly as high as 1 person in every ten people per head of population plus many millions more around the world.

The exact number of sufferers is hard to confirm as it is expected many people with the condition may have few, or vague, symptoms and may be unaware of their condition.

Many people are latent or potential coeliacs, their condition often only becoming apparent due to some major form of stress or illness in their lives or, perhaps, deterioration in their digestive system due to aging.

The disease is thought to have two influential aspects:

• Genetic
• Environmental

The way gluten affects sufferers of Coeliac Disease is not yet fully understood, but it seems to enter the intestinal cells, binding to an intestinal receptor and releasing a substance that damages the defence cells. While the specifics are not entirely clear it is understood that Gluten causes damage to the lining of the small intestine in people with Coeliac Disease causing mal-digestion and mal-absorption of nutrients.

Anyone can develop Coeliac Disease at any age, including babies, children and the elderly, although it is most common among those between 40-50 years of age.

Symptoms can range from:

• Chronic diarrhea,

• Vomiting,

• Irritability,

• Lack of appetite,

• Lack of growth in children,

• Abdominal distension.

• Fatigue

• Irritability

• Headaches

• Unexplained anemia

• Irritable bowel type symptoms

• Osteoporosis

• Infertility and recurrent miscarriages

• Skin rash - typically itchy and blistering

Diagnosing and Treating Coeliac Disease.

The diagnosis of the disease can be done through seeking evidence for verification of the function of intestinal digestion and absorption. This evidence is most often found via a D-xylose examination and determination of fat in the stools. There are also examinations with blood tests and gastroscopy.

For treatment, there must be a change in eating habits, removing forever, foods that contain gluten. The good news is that removing gluten from your daily meals allows the intestinal lining to return to normal for most people.

It is important for those with the problem, their relatives and close friends, to clearly understand which foods are permitted and how to make preparations without any risk to health. The attitude that "a small amount will not hurt you" is not acceptable under any circumstances.

There are numerous allowed foods in a Gluten-free diet, including (among others) cider vinegar, rice, vegetables, fruit, eggs, milk, meat and legumes (not canned). Cereals allowed include: amaranth, arrowroot, buckwheat, chickpeas/garbanzo beans/besan, corn, maize starch, cornmeal, polenta, faba beans, lentils and other legumes, quinoa, rice, rice flour, potato starch, sorghum, soybeans, soy flour and cassava flour or tapioca starch. Fruits including canned, juice and frozen (not sauced), can be digested with no problems unless there are issues with fructose mal-absorption.

Persons with the disease can identify foods containing gluten through the label on the packaging. If something goes wrong ALWAYS consult a doctor or nutritionist.

Unfortunately, people often remain undiagnosed and continue to suffer without knowing they can be helped.

To help create information and awareness we have created a blog, with information about coeliac disease where we hope we can assist individuals, families and friends of those with Coeliac Disease. We welcome you to visit the blog and to contribute to this online community with any information, stories, or questions.

At FG Roberts and Soy Products we are proud of our more than 50 years in business including nearly 20 years active involvement with the Coeliac community. We trust you will find this series of articles and our blog interesting and educational.