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COELIAC DISEASE / GLUTEN-SENSITIVITY

What is Coeliac Disease?
[color="Purple"]In coeliac disease the lining of the small intestine is damaged. As a consequence, the gut is less efficient at absorbing the food as it is being digested and passing through the intestine. The degree of damage is variable and the symptoms are variable as well. When severe damage has occurred there is failure to absorb specific vitamins and minerals as well as carbohydrate, fat and protein. This is termed ‘malabsorption’ and diarrhoea and weight loss usually occurs. In milder cases there are correspondingly milder symptoms which typically include variable diarrhoea and bloating of the abdomen. In many people the disease is now being recognised in the milder stages when symptoms are minor but there may be abnormal blood tests. Coeliac disease may occur at any age but is most commonly seen in infants when cereals are introduced into the diet or in young adults.
How does Coeliac Disease occur? Coeliac disease occurs when susceptible individuals are exposed to gluten in their food. This typically occurs when eating bread but gluten is also found in other foods and sauces. When the gut is exposed to gluten it causes the body’s own immune system to attack the lining of the gut. It is this process that reduces the ability of the gut to absorb nutrients.[/COLOR]Why does Coeliac Disease occur? It is not known why the condition occurs when it does. There is an increased incidence of the disease amongst certain populations but it is not inherited in a simple manner
Treatment Involved for Coeliac Disease Coeliac disease is usually diagnosed by an initial blood test and then by taking a sample of the small bowel. This is done either by swallowing a special capsule or by taking a sample through an endoscope. This is a tube which is passed through the mouth into the stomach and duodenum. The sample is then sent to the laboratory and the specimen is examined under the microscope. When examined, the lining of the small bowel is smooth and bald instead of the normal folded outline. The basis of treatment is to provide a diet free of gluten. This means excluding everything in the diet that contains gluten, especially wheat products. Rice, corn and soya flours can be used instead. It is always necessary to have the expert advice of a dietician, who will explain which foods are suitable. Additional advice may be obtained from voluntary organisations such as the Coeliac Society. Sometimes it may be necessary to supplement the diet with iron, calcium or vitamins. Many of the special foods such as gluten free flour are supplements which are available on prescription.
During Treatment for Coeliac Disease The response to removing gluten from the diet is usually rapid. Younger patients tend to improve most rapidly. It will take many months and sometimes up to a year for the lining of the gut to completely recover. Attention is also given to replacing any vitamins that have been deficient.
After Treatment for Coeliac Disease The avoidance of gluten in the diet is for life. Since small quantities of gluten can be found in many different types of food vigilance and understanding of the disease is important. Initially the doctor will carry out regular blood tests to see that important vitamins are being adequately absorbed and eventually any previously detected abnormalities will return to normal. Once this has occurred it is usually only necessary to have followed up blood tests on an annual basis.If Coeliac Disease is Left Untreated If untreated, you would continue to lose weight and vital nutrients that are not adequately absorbed into the body. There may be bleeding, anaemia and bone fractures. Eventually severe malnutrition may develop but since the severity of the disease is quite variable it is not inevitable. Those with mild disease are likely to have rather non-specific symptoms and general ill health. Death from untreated coeliac disease is rare but can occur. Coeliac disease is associated with an increased risk of lymphoma (a type of cancer) arising within the small intestine and of cancer in the gastrointestinal tract, especially the oesophagus. However, avoidance of gluten reduces this risk, and most coeliac patients have a normal life span.
Effects on Family of Coeliac Disease
Family and friends also need to be aware of what foodstuffs should be avoided. A child will need a lot of encouragement to persevere with the diet. Some families find that it is easier if everybody has a gluten free diet when eating as a family. Although it is possible to obtain gluten free meals when travelling or eating in restaurants it is often necessary to order these in advance.