Understanding Gluten Allergies/ Coeliac disease 101

Coeliac disease is an autoimmune disease of the gut.

This means that the body, when trying to fight possible threats like germs with its immune system, accidentally misinterprets some of its own tissue as the enemy, and makes antibodies against its own gut. This leads to damage of the finger like projections in the small intestine, called villi. Their function is to assist with absorption of nutrients and vitamins. It therefore makes sense that people suffering from Coeliac commonly present with abdominal symptoms such as pain and discomfort, weight loss (sometimes gain), and malabsorption syndromes, such as Vit B12 and calcium deficiencies.

Image Credit: BUPA
Image Credit: BUPA

For Coeliac disease to be “switched on”, a genetic predisposition, a meal containing Gluten and an event such as a viral illness is needed, after which, ingestion of Gluten will result in symptoms.

The most common symptoms:

Most symptoms are of the gastrointestinal tract and can range from bloating, constipation, diarrhoea, cramps, nausea, and weight loss to foul smelling stools. Symptoms of vitamin deficiencies, such as anaemia, fatigue and tingling of hands and feet, are also common.

If not diagnosed and treated, other conditions are associated with coeliac and may give further symptoms and complications. Examples of these would be

  •       other allergies, such as lactose,
  •       Other autoimmune disease, such as thyroid problems.  
  •       Skin lesions such as Dermatitis Herpetiformis, and finally
  •       Immune system cancers such as Lymphomas.

How and who do we test?

Discuss your concerns with your GP. It is recommended you should be tested if you have symptoms such as those discussed, or a direct relative who has Coeliac, as it increases your chances of being affected by up to 40%.

You will probably be sent for a tTG-IgA blood test, which is more likely to be positive, if you’ve eaten gluten containing food. However it is only 98% accurate. You may test negative and still have Coeliac disease.  A small intestine biopsy, which is definitive, may be recommended, (in children a IgA blood test and possible genetic testing with a positive history should be sufficient).

The good news is that more accurate, less invasive testing is on the horizon.

Treatment Options

There is only one treatment option at this time, a Gluten Free (GF) diet. Nutritional advice as to supplementing other nutrients that may be deficient, because of the Coeliac disease, may also be necessary.

Although the condition cannot be cured, living a GF lifestyle has become so much easier, with the information available on the web, labeling on products and the increasing selection of GF food available. I hope that this blog also gives some support for what you are going through.

If you are planning a braai, check out the great recipe for gluten free polenta bread on Facebook:

Gluten Free polenta bread recipe

polentabread

Till next time.

Angie

Should Everyone be eating Gluten Free (GF) diets?

According to Prof Noakes and other nutritional experts, this is not necessary. Only those with an allergy to Gluten (Coeliac disease), and to a lesser degree, gluten intolerance, need to follow a strict GF diet.

How do I know if I have these conditions?

Unfortunately the testing for these conditions is still very  limited,  and people who have noticed a  sensitivity to certain foods/ gluten, do not always test positive for the allergy (see next Blog on Coeliac disease for testing).

Speak to your doctor if you suspect you may be suffering from this condition. While waiting for your appointment, you can test by trial and error, by eliminating all Gluten from your diet and monitoring your wellness, especially abdominal symptoms like cramps bloating and diarrhea.

Does a GF diet result in weight loss?

Although GF diets are the latest weight loss craze, it’s the healthier eating, and decrease in carbs, that may cause some weight loss rather than the lack of gluten.

Is it harmful to eat GF if you don’t need to?

Not at all, as long as you keep following the basic rules and include all the different food groups. A GF diet can be costly and inconvenient, so it is not always practical. However, if one of the members of you family has a gluten allergy, it makes sense to eat mainly GF as a family,

Some practical tips to keep one family member’s food GF, when the rest don’t want to eat GF?

  • To keep butter, jam, mayonnaise and any other foodstuffs uncontaminated by a knife with crumbs on it, buy 2  of each. Label one GF with a neon stick-on label
  • Keep separate gluten and GF baking utensils, sieve, hand mixer, muffin pans. These can easily be contaminated with gluten.
  • Have a separate pot for cooking pasta. First cook all the other GF dishes e.g. pasta sauce. Cover them and place them onto a separate counter as the pasta boils, to avoid contamination
  • Wash hands and dry with clean towel every time after touching gluten containing food.
  • Keep bread bin and toaster separate from the main kitchen

Hope this was useful.

Till next time

Angie

Gluten-free: fact or fiction?

Dear Reader

Finding out that you, or a loved one has to eat Gluten Free from now on, is an overwhelming experience!

I fully understand. My husband was diagnosed with Coeliac disease in 2009. After the initial shock I consulted ‘Dr’ Google and any other resources I could find. It was very disappointing! A lot of the information I needed, could only be bought at a price. Hence this blog.

This blog is to share info, recipes and advice, for all of us.

‘Gluten free’ is actually a misnomer. To be able to advertise a product as ‘gluten free’, South African law requires 20 units per million or less, which still seems like a LOT to me. One can actually be exposed to gluten with so-called ‘gluten free’ products.

As a sufferer of Coeliac disease, after exposure to even such tiny amounts of gluten, one’s gut also becomes leaky and one becomes prone to cross allergies e.g. to sulphites (found in wine, grape juice, dried fruit, etc) or lactose (mostly dairy products).

Luckily there is a growing awareness of gluten allergies, and more truly gluten free products are reaching the shelves. The labelling of products is also improving. When in doubt, you can always call the manufacturer on their help line, to ask whether ingredients containing gluten have been used or not.

However, BEWARE! Recipes change and just because your favourite spice or sausage was gluten free in the past, does not mean it is today.

Woolworths for instance, have been extremely helpful, sending me an extensive list of all their gluten free products, when requested. Even so, even Woolworths advise caution, as their gluten sensitive meal plan may not be suitable if you need to be eating gluten free and their recipes may have changed even before this blog is published.

In the future I will pass on lists I have received, recipes and practical tips and invite you to contribute your own recipes, tips and comments for the well-being of everyone with gluten allergies.

Regards

Angie