The Reliance GP Blog

Gluten Free: Craze or Chronic Coeliac Disease?
Missy Tysoe March 15, 2016

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What is Coeliac Disease? 

Many people think a gluten-free diet is “on trend”. Contrary to popular belief, Coeliac disease is a chronic medical condition that results in an abnormal immune response to dietary gluten (a wheat protein found in foods). The intestine is damaged over time from gluten, which results in malabsorption (where the nutrients from food cannot be absorbed in the intestine) leading to a weakened immune system and

  • nutrient deficiencies
  • premature osteoporosis
  • abnormal liver function
  • higher rates of other autoimmune diseases, such as thyroid disease; infertility and poorer pregnancy outcomes; sepsis; and some forms of malignancy, especially lymphoma

 

Symptoms

At Reliance, Chronic disease management is an important area for our GPs to focus on. In order to maximise patient’s quality of health, we encourage people to “listen” to their bodies and understand symptoms that indicate something is not right.

Symptoms of coeliac disease may include;

  • Gastrointestinal problems, such as diarrhoea, constipation, abdominal pain, bloating or flatulence are the most common symptoms
  • Tiredness, fatigue
  • Nutritional deficiency including Iron deficiency anaemia
  • Unexplained weight change
  • Mouth ulcers and loss of tooth enamel
  • Premature osteoporosis and susceptibility to fractures
  • Infertility, recurrent miscarriage
  • Abnormal liver function tests (especially elevated transaminases)
  • In some severe cases – Peripheral neuropathy (impaired nerves affecting movement, gland or organ function), ataxia or epilepsy

 

Coeliac Disease can be hereditary and a family history of the illness can contribute to a higher risk. Other High risk factors that may add to the susceptibility of coeliac disease include;

  • Other Autoimmune diseases; Thyroid disease, diabetes, addison’s disease, Sjogren’s syndrome, autoimmune liver disease, Dermatitis herpetiformis (an itchy, blistering skin condition) and Immunoglobulin A (IgA) deficiency
  • Syndromes such as Down’s syndrome & Turner syndrome

 

Diagnoses

First and foremost – if you are experiencing any of the above symptoms, please contact Reliance on  (02) 4304 1333  or book online  to secure an appointment with your GP.

In order to correctly detect the body’s response to gluten, you must include gluten in your diet for the course of diagnoses. An initial blood test, or buccal smear (scraping of the inside of the cheek) may be performed. Some of these tests are not enough to diagnose coeliac disease alone, but may be used to exclude the possibility that the patient has it.

If you are is reluctant or unable to complete the tests on a gluten diet, you may undergo gene testing through bloods. If the gene testing is negative, coeliac disease can be safely excluded. If it is positive, then testing on a gluten diet is the only feasible diagnostic approach.

If your blood/buccal test is positive, your GP will refer you to a gastroenterologist (gut specialist) for confirmatory small bowel biopsy. This is relatively painless and will usually involve swallowing a small tube that sucks a tiny amount of tissue from the intestine, not quite as scary as it sounds! The benefits of diagnosing coeliac disease and treating your discomfort far outweigh the short biopsy process!

 

Treatment

Treatment is painless (unless you consider cutting out bread a “pain”) and involves eliminating gluten from the diet. Gluten is a protein (found in wheat, spelt, rye, barley and oats) that binds food together, almost like a “glue”. This means avoiding foods such as bread, cereal, pasta, some sauces, oats and other foods made with wheat or flour.

You are probably wondering, so what CAN I eat? Don’t be disheartened – a gluten free diet can be very satisfying and you will be alarmed how much better you feel without it. Naturally gluten free foods include; meat, fresh fruit and veggies, eggs, nuts, legumes, milk, cheese, oils and if you’re scared of missing your delicious carbs, don’t worry, you can still eat rice and corn products. Many alternatives such as gluten free pasta or crackers, are made from rice or corn. Almost every food has a gluten free substitute these days, so you can buy gluten free bread, cereal, muesli, pasta and cookies etc usually found in the health food section of the supermarket.

Some companies, such as coles, have a discount on gluten-free products for those who are diagnosed as coeliac, provided by Coeliac Australia. Further information about the discount program can be found at www.coeliac.org.au and tips on a gluten free diet can be found at www.coeliac.org.au/gluten-free
Avoid cross-contamination, such as flour on the kitchen bench, and be wary of gluten additives with “funny” names or listed as numbers on ingredients – such as those found in processed meats, ice-cream and sauces.

 

Source: www.coeliac.org.au/gluten-free

Author: Melissa Tysoe Burt

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