Coeliac Disease

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What is Coeliac disease?

• Coeliac disease affects approximately 1 in 100 Australians. However 75% currently remain undiagnosed.

• In people with coeliac disease the immune system reacts abnormally to gluten (a protein found in wheat, rye, barley and oats), causing small bowel damage.

What is Coeliac disease?

• The tiny, finger-like projections which line the bowel (villi) become inflamed and flattened.

• The surface area of the bowel available for nutrient absorption is markedly reduced which can lead to various gastrointestinal and malabsorptive symptoms.

What are the symptoms?

• The symptoms of coeliac disease vary considerably. Some people suffer severe symptoms, while others are symptom free.

• Further investigation for coeliac disease should occur if one or more high risk features are present. These include:

1. Iron Deficiency Anaemia and/or other Vitamin & Mineral Deficiencies2. Gastrointestinal Symptoms e.g. diarrhoea, constipation, nausea, vomiting, flatulence, cramping, bloating,

abdominal pain, steatorrhea3. Osteoporosis4. Autoimmune Disease (autoimmune conditions commonly occur together)5. Weight Loss (although some people may gain weight)6. Infertility7. A family history of coeliac disease

What are the symptoms?

• Other symptoms may also include:– Fatigue, weakness and lethargy– Easy bruising of the skin– Recurrent mouth ulcers and/or swelling of mouth or tongue– Skin rashes such as dermatitis herpetiformis– Altered mental alertness and irritability– Bone and joint pains– Failure to thrive in children– Delayed growth or delayed puberty in children– Many people with coeliac disease are ‘asymptomatic’, that is they have no obvious

symptoms at all.

Treating Coeliac disease

• A gluten-free diet is the only treatment for coeliac disease. Taking gluten out of the diet allows your gut to heal and your symptoms to improve.

• Where is Gluten found?– The most obvious sources of Gluten include normal bread, biscuits, cakes,

pastry, pizza, pasta, batter and breadcrumbs.– Beer also contains gluten. – Ingredients within packaged foods can also come from a gluten source. – It is essential to become ingredient aware!

Can Coeliac disease be cured?

• People with coeliac disease remain sensitive to gluten throughout their life, so in this sense they are never cured.

• A lifelong gluten free diet is the only recognised treatment for coeliac disease.

• A gluten free diet allows the small bowel lining to heal and symptoms to resolve.

• There is no correlation between symptoms and bowel damage, so even if asymptomatic (you have no symptoms), damage to the small bowel can still occur if gluten is ingested.

Long term risks of undiagnosed Coeliac disease

• The long term consequences of coeliac disease are related to poor nutrition and malabsorption of nutrients.

• Untreated, coeliac disease can lead to chronic poor health, osteoporosis, infertility, miscarriage, depression and dental enamel defects.

• There is also a small risk of certain forms of cancer such as lymphoma of the small bowel.

• In children, undiagnosed coeliac disease can cause lack of proper development, short stature and behavioural problems.

How is it diagnosed?

• Untreated, coeliac disease has significant health implications. It is important to be diagnosed and managed properly.

• The key steps:– 1. Keep eating Gluten – avoiding Gluten prior to being tested may

result in a false negative result– 2. Speak to your doctor if you think you may have Coeliac disease– 3. Ask to be tested for Coeliac disease. This involves a blood test and

small bowel biopsy.– 4. Avoid unorthodox Coeliac testing and treatment procedures

commonly promoted by alternative therapists.

What can you eat on a Gluten free diet?

• There are 4 groups of food that are suitable for those on a gluten free diet: Naturally gluten free foodsE.g.

Fresh fruit and vegetables, fresh meats, eggs, nuts and legumes, milk, fats and oils and gluten free grains e.g. rice and corn.

Products labelled ‘gluten free’

What can you eat on a Gluten free diet?

Products that use the ‘Crossed grain logo’Products displaying the crossed grain logo are endorsed by Coeliac Australia and are safe.

Products that are gluten free by ingredientIf any ingredient in a product is derived from wheat, rye, barley or oats, then this must be declared.

Where can I get more information?

• Your doctor• An Accredited Practising Dietitian• Coeliac Australia – www.coeliac.org.au

Any Questions?

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