Coeliac (pronouced 'see-lee-ak') disease is a condition where the immune system reacts to gluten. The lining of the intestines have tiny hairs called villi; when gluten is eaten, the immune system reacts and damages these villi. Due to the damage of the lining of the intestines, nutrients are not able to be absorbed into the bloodstream. This in turn causes malnutrition as the nutrients are not able to be transported to the cells via the bloodstream. 

Coeliac disease is a genetic disorder and is caused by an immunological (allergic) reaction to gluten.  Gluten is a family of proteins that is found in certain grains such as barley, wheat, rye and sometimes it is found in oats. Kamut and Spelt also contain the gluten protein.

If one suspects that they may have coeliac disease, it is essential to consult a doctor for diagnosis.  Once a diagnosis is made, it is important to seek advice from a naturopath or nutritionist.  They can give invaluable support and practical advice.  This is of major benefit in the early stages of the diagnosis.

Individuals with coeliac disease may develop the one or more of the following:

• Diarrhea;
  
  
• Steatorrhea (the presence of excess fat in stools);
  
  
• Weight loss;
  
  
• Flatulence;
  
  
• Zinc deficiency;
  
  
• Iron deficiency anaemia;
  
  
• Weakened bones;
  
  
• Bloating;
  
  
• Abdominal distension;
  
  
• Excess gas.

Managing Coeliac Disease

There is no cure for coeliac disease. The best way in which to manage the symptoms and to maintain health and wellbeing is through a very strict gluten free diet.

The basic principles of a gluten free diet include:

• Avoidance of oats, wheat, barley, rye. Many dispute the avoidance of oats.  However, due to cross contamination with wheat, is best to avoid oats in the coeliac diet.
• Avoid processed foods which are high in wheat flour. It is important to check the ingredients of foods such as ice cream, salad dressings, cakes, biscuits, crisps.
• Avoid wheat starch, which is commonly used as a binding agent. It is therefore important to check for this in the ingredients.

Individuals with severe malabsorption may be malnourished. They will therefore develop deficiencies in certain vitamins and minerals. In these cases, it is important to consult with your nutritionist or naturopath who will advise on the best nutritional supplement program. A full blood test may need to be taken in order to confirm any deficiencies.

Most people respond well to an elimination of gluten in their diet.  In these cases, the villi usually repair themselves and symptoms are usually alleviated.  Failure to respond to a gluten free diet usually means that the person is either:

• Not eating a strict gluten free diet and is still consuming small amounts of gluten; or
  
  
• The ingestion of gluten is unknown; or
  
  
• There may another pre-existing condition (such as irritable bowel syndrome) where digestive symptoms may still be present.

In summary, coeliac disease can be managed well with a strict gluten free diet.  There are many gluten free products on the market today.  This makes it much easier for the consumer for adhere to the diet. The gluten free diet should be strict and even small amounts of gluten will cause undesired symptoms.