Coeliac Disease

Following from my post about food intolerance’s, I have received my blood test results. I have been diagnosed with coeliac disease which causes inflammation in the lining of the small intestine. My results will be confirmed at a follow-up appointment but from now on I cannot eat gluten or wheat food products. Although it has been distressing to find that I have limitations to my diet, I am relieved that I know the cause of my problem and hopefully my symptoms will calm down as I change my food intake.

Wheat and gluten excluded from my diet
Wheat and gluten have to be excluded from my diet

Interestingly, coeliac disease is not a food allergy or intolerance. It is in fact an autoimmune disease. Since my sister has type 1 diabetes, another autoimmune disease, it is not surprising that I have one too; if a close family member has such a disease there is a 1 in 10 chance of developing one. My diagnosis means that my body actually makes antibodies against gluten. Therefore, my small intestine identifies gluten as harmful; responding in the same way as it would to pathogens. It reacts with the gluten leading to the development of inflammation in the lining of the intestine. The villi that line the small intestine become flattened due to this inflammation. Villi normally help food and nutrients to be digested and so with coeliac disease you do not properly digest your food. This is why I have had limited weight gain, abdominal pains and tiredness; the main symptoms of the disease. The average time from the first symptoms to diagnosis of coeliac disease is 13 years in the UK; this means I could have been living with it for nearly my whole life.

The impact of coeliac disease on the lining of the small intestine
The impact of Coeliac disease on the lining of the small intestine

My blood test for coeliac disease was obviously positive as there was a high percentage of the antibody that occurs in the disease in my blood. My follow-up appointment may include a biopsy where a small sample of tissue is taken from the lining of the intestine in order to examine the typical changes that coeliac disease causes. This is carried out by using an endoscope which is a thin flexible tube that is passed down the oesophagus, through the stomach and then to the small intestine. In addition, I may have to have further tests to see how poor absorption of food has affected me, such as blood tests for iron or protein levels.

Endoscopy is used to confirm coeliac disease
Endoscopy is used to confirm Coeliac disease

The main treatment for the disease is a gluten free diet. The symptoms should then go within a few weeks. Wheat, barley and rye are the main foods that contain gluten. This means breads, pasta, cakes, pastries and most cereals are out of the question. Nevertheless, potatoes, rice, maize, corn, fruit, dairy products and vegetables are all allowed. The main disadvantage with Coeliac disease is eating out. Processed foods, fast foods and ready-meals almost always contain gluten. Care has to be taken with foods such as french fries in McDonald’s; although they do not contain gluten, they are likely to be contaminated with the various other foods containing gluten that the restaurant is cooking.

Image of the small intestine before and after coeliac disease
Image of the small intestine before and after Coeliac disease

To avoid all symptoms and complications I will have to avoid gluten for life as even small amounts can sensitize the gut. Furthermore, I may have to take vitamin supplements for the first 6 months to replace deficiencies while my gut is returning to normal.

Coeliac disease means I now have an increased risk of developing other conditions such as the thinning of the bones (osteoporosis). Commonly people think that consuming small amounts of gluten will not matter. In reality only a small amount can cause symptoms to return.

The disease affects 1 in 100 people in the UK, with anyone at any age being impacted. If you think you may be Coeliac you should see your doctor. A gluten free diet should not be attempted before diagnosis as if you go on this diet before the blood test then it may give negative results. Hopefully I will be able to live free from the symptoms of Coeliac disease if I avoid gluten! For more information visit: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/celiac-disease/Pages/facts.aspx

4 thoughts on “Coeliac Disease

  1. Hey! I too am allergic to gluten and have been since I was 10. We have a long family history with coeliac’s diesease and have lots of experience. If you need any help with your new diet/lifestyle at any point or just want to chat about it just ping me a message on my blog!

      1. Hi. The Coeliac UK website is great at providing advice for those who follow a gluten free website and they have a page with details about eating out: https://www.coeliac.org.uk/gluten-free-diet-and-lifestyle/eating-out/
        Luckily most chains of restaurants now have either a gluten free menu or options on their menu.
        Pizza Express is quite good- on their menu they have symbols ( I think they’re NGCI symbols- no gluten containing ingredients), and all of their pizzas can be made on a gluten free base. For other italian restaurants, Zizzi, Bella Italia and Ask and Prezzo all have gluten free options whether it’s gluten free pasta options for any of their sauces, risotto or a gluten free pizza base. Carluccio’s also has a fab gluten free approach, their GF menu is about the length of a normal restaurant’s whole menu.
        In Yo Sushi they have an allergens menu and then you can order specific dishes instead of grabbing something off the belt. Wagamama also have an allergens menu specifying whether each dish is gluten free, not gluten free or can be adapted to be gluten free and they have a reasonable amount of choice too.
        Chinese is generally harder to do gluten free but try looking up your local Chinese restaurant menu and see if they have an allergens section.
        TGIF is also quite good with a gluten free menu as part of their allergy menu online. Giraffe is not so good but still has some options.
        On the takeaway front you’ll probably be pleased to hear that Domino’s deliver gluten free pizza (pick the gluten free base option) although not all their toppings are gluten free so beware (many people don’t seem to recognise that sausage often contains flour). Pizza Hut also do some gluten free stuff.
        For cafes, EAT and Pret usually have some hotpots/soups that are gluten free eg. the eat chilli con carne is great. Cafe Nero, Starbucks and Costa often have a gluten free sandwich of some kind but it varies on how big the individual cafe is. Wasabi and Itsu sushi is often gluten free but watch out because soy sauce isn’t very often gluten free and so often on their packets they say contains gluten but it’s only the sauce that does.
        MacDonalds chips are gluten free (they have dedicated fryers) and lots of their ice-cream style puddings and milkshakes are as well.
        Overall it’s not as hard as people think and even individual little cafes and restaurants often have GF options. Just make sure that you say to the waiter that you are ALLERGIC not just on a GF diet or something as that way they take more care and often wipe down surfaces so there is no contamination. Just watch out for sneaky little things like if they fry their chips in the same place as chicken nuggets etc. Also other GF tricks are things like mars bars and branston pickle, which look like they should be gluten free and aren’t, so read the packaging of everything!
        Often it is hard when your friends want to go somewhere where you can’t eat anything or you can’t eat what your friends are, but I’ve learnt to carry snack bars and stuff around in my bag and often you can buy a GF M&S sandwich or something after/before they eat.
        Of course supermarkets have a whole GF section and in their freezers you can usually find frozen GF pizzas and stuff like that.
        I hope this has been useful and good luck with your new lifestyle- if you have any more questions please just ask- as I say I have lots of experience!

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