Coeliac disease (CD) is a common autoimmune disorder where the body attacks itself. It occurs as a consequence of gluten intolerance and affects approximately 1% of the population. Gluten is found in all food and non-food products that are made from wheat, barley and rye. Oats contain some lower levels of gluten but the levels are not always problematic for Coeliac sufferers, however as oats are often processed in the same factories as wheat, barley and rye they should be eaten with caution.
When these products are consumed, the disease activates chronic small intestine inflammation and erosion of the intestinal villi which can lead to nutrient malabsorption and potentially deficiencies, with iron and folic acid deficiency being the more common deficiencies. Although it is usually thought to be solely a gastrointestinal disorder, many will be surprised to know it is in fact a systemic disorder affecting the whole body. Gluten ingestion can trigger inflammation in several other areas of the body, manifesting itself in many ways and consequently it can be extremely distressing for the individual, severely affecting quality of life. For example it can cause skin disorders such as psoriasis and eczema, fatigue, and also more serious conditions such as type I diabetes, heart and/or liver disease, anaemia, epilepsy, osteoporosis amongst others. Sufferers may feel like their symptoms are unrelated to those typically associated with an intolerance such as abdominal pain, bloating, diarrhoea etc which means that Coeliac disease often goes undiagnosed for years. It is however becoming more widely recognised and acknowledged by the Medical Profession and diagnosis is improving.
A gluten free diet is currently the only method of treatment as there is no approved medication, however gluten is extremely difficult to avoid completely as cereal use in food products is widespread and it is often hidden in many products unexpectedly e.g. in cosmetics. It is now possible to get gluten free oats along with better and more tasty gluten free breads and other grains, so CD sufferers should look out for these options.
Prolonged exposure to gluten in Coeliac sufferers can result in mortality, therefore in addition to attempting to remove gluten, other therapeutic methods should be considered. It has been acknowledged that the gut balance (microbiota) is vital for keeping a healthy state and reductions in beneficial bacteria can cause imbalances and potentially contribute to diseases such as Coeliac disease. One study published in 2010 by Journal of Leukocyte Biology investigated the effects of the probiotic Bifidobacteria on the immune triggers of Coeliac disease. They found that the inclusion of this beneficial probiotic improved the gut state, immune reaction and disease outcome for those with CD. In addition to probiotics and a gluten free diet, anti-inflammatory nutrients such as fatty acids will also help to reduce the inflammation across the body. Taking supplements such as glutamine and arginine can help to repair the intestinal damage to allow the villi in the small intestine to grow back and begin to absorb the nutrients again (2).
These nutrients are not only beneficial for those suffering with Coeliac disease and can benefit everyone, as they allow the body to be in a balanced state and reduce inflammation which can also be a cause of many conditions including IBS. If you think you may have Coeliac Disease or would like to be tested for it, you should contact your Health Practitioner or a local BANT or Nutrition Society registered Nutritionist.
Written by Lauren Foster
(1) G. De Palma,* J. Cinova,† R. Stepankova,† L. Tuckova,† and Y. Sanz Pivotal Advance: Bifidobacteria and Gram-negative bacteria differentially influence immune responses in the proinflammatory milieu of celiac disease. Journal of Leukocyte Biology, vol. 87 no. 5 765-778.
(2) Sukhotnik, I., Slijper, N., Pollak, Y., Chemodanov, E., Shaoul, R., Coran, A.G., Mogilner, J.G. (2011) Parenteral omega-3 fatty acids (Omegaven) modulate intestinal recovery after intestinal ischemia-reperfusion in a rat model. Journal of Pediatric Surgery, Vol. 46, Issue 7, Pg. 1353-1360.
(3.) Image courtesy of Grant Cochrane